mariem

I have thought about Mexico as a possiblity but I would like to get my insurance to pay for it if all possible.

I am totally kicking myself right now. Next month I will be on BC/BS of Mass. PPO with a $15 co-pay and no co-pay for surgery or hospitalization. Also, no exclusion for WLS. I am like a lot of people who have always struggled with weight. I had no co morbidities so I rarely went to the doctor. I despised going to the doctor because I was too embarrassed to get weighed. That was the real reason. I do have a few trips to the doctor for pap smears (not as much as I should) and for the rare occasion I was actually ill. I dont however have 5 years of being weighed in at least once per year. The last time I went to the doctor was Jan 07 so right there it's been 17 months. I can drag up what records I do have but I don't have what they are looking for. If I knew I was wanting to have lap band surgery 5 years ago I would've made sure to go to the doctor more frequently. What I can prove is that for the times I have been to the doctor I have been at least over a 40 BMI. 5 years ago I went on WW so I got down to 35 BMI but that only lasted a year. I can also prove that since I have been in my 20's (I am in my 40's now) I have struggled with my weight and have always been around 40 BMI. The guy I talked to at the doctors office has told me they usually make no exceptions. I am really depressed right now. What is everyone's take on this?

Kristiebandy So when did you start this process? When was your orientation? Do you feel you are having this done much more quickly than if you had gone somewhere else?

I finally just told my husband a couple days ago that I am going to have this done in the near future. This is after researching the lap band for nearly a year and now finally getting insurance next month that doesn't have a lap band exclusion. He is not very supportive. He said that as long as it doesn't cost much out of pocket he doesn't care. My mother in law has known for quite some time that I have been looking into it and is totally supportive. She would be, she's the only family member in my life who is obese and understands the struggles. She told me, "Do it and don't look back, if I were your age I'd do it" She is 74 now so it's not a choice. She is an RN and I want her to be there for me before and after surgery. Not my husband. (is that weird or what) I have yet to tell my "skinny" family. How I got my fat genes is beyond me. I've always known I had the misfortune to have problems with food. My mom just really controlled my eating from an early childhood. It wasn't till I was out of her control that I really picked up the weight. I was always a normal weight under her control, but it wasn't easy. I am the only one who really struggles with weight. I just don't want to hear about it from them. I know my parents will tell me that if I just diet and exercise then I'll meet my goal (as if that has worked the past 24 years!) I don't think I'm going to tell them. I feel badly for not even telling my parents that I will be going under the knife but I don't see what I can gain by telling them. We are very close and talk nearly everyday. This is just something they don't understand and I don't think they ever will.

I was originally going to go to Bridges orientation but they scared me off by telling me I needed to be on a 6 month medically supervised diet. When I called WLIA they told me that according to BC/BS of Mass. that there was nothing stating about a 6 month medically supervised diet, (though it would be in my best interest to get to a primary care doctor and get started on a relationship with her and talk about the lap band and my goals etc) I just have to have documentation of my weight over the past 5 years. I also asked Bridges when I called when would they actually look into what was needed to be approved and they informed me they would process everything when I was done with the 6 month diet. Maybe I just need to call them again and see if I get a different answer?

I went to the orientation yesterday at WLIA. I have to say I was impressed with Dr DeBarros and I liked that they made it seem as if it was so much easier to go with them because they will work to make sure my claim will be approved and will go the extra mile. What I didnt like is the fact that the insurance I will be on will most likely cover 100% of the surgery with no co-pays yet I will still have to pay a co-pay and a deductible. This is because one of the doctors (and both will be there during the surgery) is not on the BC/BS plan. This most likely means my totally covered 100% procedure will cost me around $2500 - $3000 when you also take into account the program and other fees. I have a few things that I am a bit worried about. First of all I dont have a primary care physician and my records are very sketchy over the past 5 years. A couple trips to urgent care for strep throat, a visit here and there for other things but nothing with exclusively one doctor. Other than that I'm pretty much a "healthy" person with a BMI of around 42. No, I dont consider having a 42 BMI to be healthy but I dont have any other problems. My weight has fluctuated a lot over the past 5 years but I've always been around the 40 BMI range. I am now really regretting not seeing one doctor and having that person have all of my records. (Does urgent care even keep records easily at hand for the person who came there only once three years ago?) Ok yes, I know this is getting long so I'll cut to the chase. I went to WLIA and they are asking for $2000 in program fees and other incidentals. Is this normal? It's sort of worth it to me if they can get me approved because of my sketchy past where others wont do much to get me approved. Simply put are these programs fees the norm and how much do the other places do to get you approved for surgery?

I just go the call today to confirm that I will be at the orientaion at WLIA tomorrow at 1pm. (anyone else going to be there? Send me a private message) I talked again this time with some guy who I again told them I will be on BC/BS of Mass next month. I told him from the sounds of it they will cover the entire cost of the surgery itself. Like someone else told me here he informed me that one of the surgeons isnt on that plan and will be out of network. I really dont understand that. Why if they are "partners" working in the same office would one of them not be on the BC/BS plan? My out of network really wont be too bad but it's the principle of the whole thing. Has anyone ever asked this from them and what was the answer? Isnt the simple solution to just ask the one who accepts BC/BS to perform the surgery?

I'm sorry to hear that! Something else the Wii Fit does......My friend got hers yesterday and she is a huge fan of the Wii anyway. She had a perfect Mii for herself all pretty and slim. She went through the set up process and as you, it asked her to step on the scale. Her slim looking Mii all of a sudden turned into a plump Mii!!! She was laughing at me when she was telling me about this. She said, well at least it's honest! She actually said it's a lot of fun, it wont be long till you get to participate! As for me, I have a Wii and waiting for my boys to get it for me for my birthday.

Im not trying to scare you here but my friend who had a hysterectomy a year ago had some of the same problems. She was winded from just walking. She had no engery. She complained to anyone who would listen to her that something wasnt right. No one would listen. Finally she got someone to listen and what was found out is that she had blood clots in her lungs. Has this possiblity been ruled out?

Havent been banded yet but I had mine out just 4 weeks after having a c-section. (childbirth I was told can trigger gall bladder problems too) When I had my first attack it was 2 weeks post op. I thought I was having a heart attack. At least you know what it was. Mine landed me in the ER too. It must have been really bad. I was a bit sore afterward but it wasnt too bad, it's a lot better than worrying when the next attack will be! Good luck!

I just looked at your weight loss. For being banded just last October you are doing awesome! I am 5'9 and around 292 and some change. Been up and down since I was 21. I'm ready for a huge change in my mind and in my eating. 12 years ago I got down to 200 and I was loving life more than I was loving eating. I dont know what happened but I'm ready to start loving life again!

I will surely do so! My apointment is June 4 and I am keeping my fingers crossed. Hopefully she is receptive and understanding. If not I am not afraid to tell her what my goals are and what I need in a doctor. If she is unwilling to do so I have no problems shopping around. This doctor is around the Bell and Parkview area. I'll keep you posted. I plan on going to my orientation for the lap band at WLIA either tonight or Saturday. I was going to go last Saturday but I ended up having "soccer stuff" to do with my teenage son. Forever a soccer mom lol

Wow, I think we've all been there at some point of time. It's quite embarassing. I was traveling to Chicago from Arizona last January on American and had a window seat. I tried and tried to get that seat belt to latch. It could touch but I just couldnt get it to latch because I am too big! So there I sat all flight pretending I had a seat belt on because I was too embarrassed to ask for a seat belt extention. Yes, Im still that same weight and it's for many reasons that I dont want to be like this anymore! I cant wait to get my lap band. Im right at the beginning of the process now.

I have my appointment for a doctor in Surprise on the first week of June. Hopefully she is receptive to being banded. I asked all the right questions when I called the receptionist. She informed me that the doctor does have a couple patients who are banded. That's a good sign. I was originally going to go to Bridges on Monday but after talking to them on the phone I didnt really like the reception I got. I was asked which insurance I have and she just assumed every BC/BS would be the same when she told me I would have to have a 6 month medically supervised diet. I asked when would they actually look into my insurance to see the requirements to make sure I am doing everything I am supposed to. She informed me that it would be till AFTER all the tests and my diet were over with. I called WLIA today and I was able to talk with the insurance person. She asked which specific policy I had for BC/BS. She informed me that nothing is required for a 6 month diet but I should keep the doctor apointment just in case and Im going to need all the help I can get with this anyway and establish myself with a primary care doctor. My insurance isnt going to kick in for another 3 weeks or so and the woman at WLIA said they will do everything for me as far as telling me what appointments I need to make and the timelines etc. It just seemed so much more organized and less complicated. Anyone with happy results out there with WLIA or any opinions at all?

Congrats!!! Hopefully I'll be following you before too long!

I did ask....they told me to look around on my own. To call different doctors and ask if they deal with "bariatric patients" and are they supportive of the lap band. It seemed as though they couldnt get their mind around the "bariatric patient" idea. I think they had the impression I was bed ridden or something lol lol

Just out of curiousity, where did you get your surgery done in Mexico and what sort of timeframe did you deal with. Did you have someone go with you? My mother in law is absolutely supportive of this decision and would go with me (she is an RN) my husband however I know without a doubt would be petrified for me to go to Mexico for surgery. Im almost wondering if it's better than jumping through these hoops and waiting for over 6 months.

I have read a lot (for a year or two) about being banded. I have decided this is for me. Finally my ray of hope was when my husband took a job offer and is starting on June 1 with GREAT insurance and I think one that will finally pay for it! I will have BC/BS I am in the far West Valley and need some help here. I have a seminar date set for next Monday at Bridges. I have heard pros and cons about them. They told me I also needed a 6 month diet for BC/BS under my primary doctor's supervision. First of all, I "fired" my doctor two years ago and havent been sick since so I havent been to the doctor. Well, I lie, I was sick once but I went to urgent care. She is not at that practice anymore anyway so it's not like I can go back to her even if I wanted to. I need to find a PCP around here to do a medically supervised diet for 6 months and also one who is obviously supportive of the idea of me being banded. One around the Surprise/Peoria area would be best. Also, if you had to do it all over again who would you select to do your surgery? Are there any doctors that you would never go to because of how you were treated? Incompent office staff etc? Thanks for any and all help!:frown:

Ok so I'm bad, I dont have a Primary Care Physician. I do go to the dr when I get sick and I do have insurance. It's just that the doctor I selected 2 years ago, I really didnt like. Then last year she left the practice where she was at anyway. Does anyone know of a good PCP in the far NW Valley of Phoenix? I need to find one who will have no problem with my goal of being banded.

I have posted this on my blogs but I am so curious about being approved for WLS. My current insurance is some sort of cheap Cigna plan which there are very expensive co-pays, deductibles for labs PLUS 10% on top of the co-pay and a few exclusions (WLS of course is one of them) I never heard of any Cigna plan having a co-pay AND a deductible for an office visit but that's what there is because my husband has been working for this tight wad employer for 19 years now. FINALLY (yippeee) my husband has accepted a job for a great employer who really pulls no stops at making sure their employees are happy. My husband accepted the job and he starts on June 1. The insurance we will be on starting June 1 is BC/BS of Massachusetts, Blue Care Elect Preferred (PPO) there is only a $15 co-pay with NO deductibles as long as we stay in network. (yes strange I know, we do live in Arizona but Massachusetts is where the employer is) There is also no charge for surgery or hospital stays. I have never seen such a wonderful comprehensive plan such as what I have here. Nothing is listed about WLS but when I did go to the generic website for this plan it looks as if I would be covered as long as the employer didn't exclude it on it's plan. I highly doubt they did. Has anyone ever dealt with this certain plan and what sort of luck have you had? Any info would be great! Thanks! Current weight 292 5'9

It is BC/BS of Massachusetts, Blue Care Elect Preferred (PPO) I have googled this a lot today and have found that as long as there is an exclusion for WLS there seems to be no problem getting banded. (I HOPE!!) I dont think the employer would put a specific exclusion for WLS because what I am reading it sounds as if they pulled no stops at making sure they have a great policy. Soooooo unlike my husband's current (nearly former) employer.

It is BC/BS of Massachusetts, Blue Care Elect Preferred (PPO) I have googled this a lot today and have found that as long as there is an exclusion for WLS there seems to be no problem getting banded. (I HOPE!!) I dont think the employer would put a specific exclusion for WLS because what I am reading it sounds as if they pulled no stops at making sure they have a great policy. Soooooo unlike my husband's current (nearly former) employer.

No, not from Ireland, Lyn but I do go there a lot :rolleyes2:

I've been giving Juice Plus to my son. (I should take it myself!) Does it work? I really don't know. Is it a scam? I really dont know. But I do know that they DO list the ingredients on the bottle. My mom said it really helps here that's why I'm giving it to my son who has food issues and severely underweight. (yes it's hard to have food stuff for my son which are high in fat and not be tempted grrrrrrrr)

Ok, So this is my first entry on this blog. A bit about myself. I have always struggled with my weight. I was never overweight as a child or even a teen. I think this was because my Mom really was my "food monitor" I never realized that till now that I am 44. It wasn't until I got out of my Mom's grasp did I gain loads of weight which of course for most kids is when they go away to college. Before that point I was very active. I was involved in Sports and Cheerleading but still was considered "big" compaired to the other girls. I knew I was different even though I was what I now consider at a very good weight. I am 5'9 and back then I was consistantly between 145 and 160 until I was 20. At 20 I went away to a University after staying at home for 2 years while getting my AA. My own parents were in shock when I came home for Thanksgiving weighing around 180 at that time. By Summer I was around 200. From there it was a vicious cycle. I did get engaged that Summer. My poor fiance (now husband) knew me as the good looking 20 year old and now had a overweight fiance. By the time we married the following Summer I was at 225. 4 years later came my first son. I had got up to 260 but went on diet center and immediately got pregnant but got down to 220 first in about 8 weeks. My pregnancy weight topped out at 280. 4 years later when I got pregnant again my pre-pregnancy weight had gotten to 306. By the time of delivery I was 325. My weight was effecting a lot of my activities. 3 years later (this was back in 1996) we moved to Phoenix. I found a new love in my life....chatting online. I was bored here in Phoenix and had no friends so I took to chatting online. Somehow that sparked me not eating and being able to easily diet. I still dont know the reasoning but I was happy about it. I had gotten up to 337 and within 12 months I was down to 200 pounds. I felt great and loved life once again. I was comfortable on an airplane, shopping in normal shops etc. Now, 12 years later, after many ups and downs I am at the highest weight I have been since my huge weight loss. I am back up to 292 and really wanting to get banded. I love to travel and it's embarrassing to squeeze into an airplane seat. I do it often but I am usually praying the night before that no one will be sitting next to me. I already have a trip to Ireland planned in September with my Mom and Sister and I know I am going to spill over into their seat. Not that they dont know how big I am, I just dont like to be reminded! I also know I have sleep apnea though it hasnt been brought to the attention of my doctor. I am tired all the time and my feet hurt when I wake up in the morning and take those first few steps. I remember them doing that when I was at my highest weight ever. That all went away when I dropped all that weight but now in the past few months those feet pains are coming back. Other than those "ailments" I am quite healthy. No high BP, no diabetes, no limitations etc. Wow this has gotten very long!! Anyway, I hope I am well aware of what being banded will do for me and I am going into it with my eyes open. My insurance now is Cigna and it's such a cheap insurance option that my husband's company selected. It's not even normal cigna, it's got loads of exclusions and huge deductibles and co-pays. I was so happy that my husband (after working for 19 years with his current company) has just taken a job yesterday with a new company!! :rolleyes2: When he was interviewed he found out that it's a great health plan. Its BC/BS of Mass. Some sort of Blue select program. From all it covers and how generous this insurance seems to be I feel as if they have probably not excluded lapband as an option like what the Cigna policy did. I see this is my ray of hope! I need to sit back till around June 1 when I am finally covered on this insurance and then find out what to do to get this process rolling!