kfgates

Hi, I would love to keep in touch. My date got moved and it is actually a week from today...Feb 11th. I am really looking forward to my new life, but find myself mourning food right now. I look at things and think...gee i will never eat that again. My goal was to loose 20 lbs before surgery and I lost 21. I really wanted to be closer to 200lbs, but am at 215 now. I also wanted to make sure my liver was not too fatty for surgery. I do not want to gain any back. I am going in for my pre op on Friday at 2pm. Right now my only REAL concern is getting stuck. I live 1 hour from my surgeon and the local hospital won't touch my port. I HAVE to drive to the hospital that he works out of. I understand it has something to do with the bands warranty. Do you have your pre op date yet? Keep in touch. Kimberly

I was approved after 2 days...YOU CAN NOT SEND IN TOO MUCH INFORMATION. My BMI was under 40 as well. I did have multiple comobidities. I got letters from my OBGYN, peditrist, pcp and i even wrote one heartfelt letter from me. I kept everything I ate for 6 months and I did loose weight, but not that much. K

BC BS approved me after 2 days. My BMI is 35-38. My comobidities are many....herniated discs, stress incontinence, pre diabetic, extreme joint pain, plantar faciatis, (fallen arches) and others. I made sure I did everything they required and doted my i's and crossed my t's. I even got letters from not only my PCP, but my OBGYN, my pediditrist and a very heartfelt lettter from me. You can't send them TOO much information. I even printed my weekly diet sheets for 6 months. I am scheduled for surgery on Feb 13th (yup it is a Friday) so I am waiting for the other boot to fall...ie: oops we called the wrong patient, or oops you lost too much weight and they changed their minds. I was so sure I was going to be denied that in order to not fall into a complete depression I did loose some weight. If history repeats itself I would have gained it back without the band. Please feel free to ask questions if you have any. K

Wow why so much out of pocket? I have BC BS of CA and that is not even close! Who gave you that figure? BC or doc's office. I too was approved after 2 days...I was overjoyed! Good thing about that much out of pocket is that you can claim that entire amount on your taxes next year. K Blue Bug I can't believe how much BC BS varies from state to state! That is bittersweet, yea they will cover you, but yuck you have to pay the bulk of the procedure.

It was my experience that if you dot your i's and cross your t's with BC BS you will have NO problems. You can't send them too much information and yes make sure you weigh in 6 consecutive months. The last thing you want is to only do 5 and have to start all over again. I was where you are 7 months ago and I know this may sound foolish, but these 6 months will go fast and you can't do too much research into your procedure. At first I was mad that they were making me jump thru hoops, but am now greatful that they made me wait. I now know I am doing this for the right reasons and I am very prepared for my future with the lap band. Good luck! Oh yea, they approved me in 2 days! k.

As for protein shakes I have tried several! I actually like the EAS chocolate powder mixed with skim milk. It is very fine and dissolves completely. It has 23g protein in the mix and the added 8 from the milk is a generous 31g. It has 130 cal and 2.5g fat. I highly recommend it! Kimberly

I noticed you are a teacher...I teach Pre School and want to be able to go back to work after a week and a half. How long did you take off?? We have Feb Vacation so I am looking at having the surgery Friday the 13th and back 10 days later. Were you tired? Kimberly

Hi Sarah, I don't know if you remember me..I had tons of questions about 6 months ago...well as of Thursday I was approved. How are you doing? I am looking at Feb 13 (yes that is a Friday..lol) for a surgery date. I have all my other dates so it is all down hill from here. I look forward to hearing from you! Kimberly

Hello, I was approved as of yesterday and they are shooting for a Feb 13th surgery date. I am a teacher and we are on vacation for a week so the timing couldn't be better. I have not posted for some time becasue I had all but accepted the fact this was not going to happen for me. I will post more later..just seeing who is being banded in Feb. Kimberly

Hi Sarah, I am still in insurance hell!! My husbands company still has not told us who we are switching too so I have been on pins and needles. My PCP has written yet another letter regarding my 6 month diet...It clearly states that I have been on multiple diets for over 6 months, have lost weight but keep putting it back on. I know he is trying, but am sure Cigna will kick it back. I have to try tho. I need to get approved no later than Nov 10th (that means I will have to submit right after my psyc appt on the 19th of October) I am shooting for the week before Christmas for the procedure. The anxiety of not knowing is making me crazy!! I know my husband is concerned, but there is really nothing we can do but wait. On a lighter note...hope everything is going well for you folks!! I am back to school in just over a week...I really miss the kids. Kimberly

Congrats!!! If you find out what took so long let us know...I will be looking to submit to Cigna the end of November...It can not take as long as you because my husbands company is switching insurance and the new insurance does not cover the lap band. I can't wait till I can post such good news!! Good luck Kimberly

My husbands company may very likely be switching from Cigna to an inferior company...needless to say they do not cover baraitric surgery. Cigna does and has been just wonderful this far. I am not due to submit my paperwork until the end of November (END OF 6 MONTH DIET) and we switch over Jan 1st....It is VERY likely that they may not make a decision until after Jan...anyway now I am looking into cobra....I would have the same coverage, and I would only sign up myself...the rest of the family would go with the new insurance....has anyone had to switch to cobra during this process, or had to go from Cigna to Cigna cobra??? Thanks for any insight you may have. Kimbelry

Has anyone had any dealings with American Heritage??? It is apparently a subdivision of Allstate. I would appreciate any insight. Kimberly

You two are great...It means a great deal that you respond. You aren't going to believe this.....I called HR and they know nothing...I called an Allstate agent and they were clueless and said they had no idea that Allstate was carrying health insurance. All I can do now is wait and see what happens....I am also going to try and see if my PCP has any record of a weight in May...that would push my file date up to November and could set up surgery by the middle of December. I have my weigh in with him on the 22nd so I will try that...thanks again ladies...I have just worked so hard, researched, got letters from 4 other docs re my weight!! I will let you know what happens. Kimberly

When are you going to file your claim?? I am curious what they will say. Keep me posted. Kimberly

Hi Sarah...I am so upset....I just found out that my husbands company may very likely be changing insurance companies. From Cigna (after 10 years) to Allstate...I thought all they insured was cars!!!! Worse yet I can not find out any information on Allstate health insurance. I researched the beans out of Cigna and am terrified Allstate is not going to be as easy to work with. I will be done with my 6 month diet Dec 16th and we would be changing Jan 1. What horrible timing...OMG if this change ruins everything I will be devastated. DO you know anyone with Allstate insurance??? Kimberly

I just found out that my husbands company may be changing insurance companies...we will be going from Cigna (after 10 years) to Allstate. Does anyone know anything about Allstate?? I have put so much into this and figure why would Cigna cover such a surgery if we are changing anyway...I will not be done with my 6 month diet until Dec 16th and we are changing insurances January 1. What crappie timing!!!!! I am soooo upset!! Thank you for any help...Kimberly

Hi Sarah, I just made my Psyc appt. It is a 2 1/2 hour appt...what the heck do we do for over two hours?? I understand there is some sort of "test" but not really clear what it is about. I am also a little disappointed that it is a man. I would feel more comfortable with a woman, but I am going to the Dr. at the Augusta hospital. I was told that they were booking into November, but got in for the third week of October. No problem because I have to complete my 6 month diet for insurance. Did you have an "out of pocket" amount that your insurance requires?? I am asking because I have a $2000.00 per year out of pocket and am wondering if the hospital is going to require that amount up front or will they bill me. I know about the $500 for the office, I just want to make sure I have the funds ready when I am ready. If I got everything done and had the procedure before Jan 1st I would only have to come up with less than $1000 because I have already paid out so much. That is a dream because I won't be able to submit to insurance until the 20th of December. You have been in my prayers Sarah and it is very kind of you to share your experience...it kind of gives me an idea of what I "may" expect. God Bless Kimberly

Hi Sarah, I have been reading thru your thread and am so sorry to hear about your difficulties! I hope things are a little better for you now...please don't get hung up on the water weight gain...you know as well as I that it is only water and will be gone shortly. What does Huy have to say about what has happened to you? Is is common? I really liked him a lot and am looking forward to having him for a surgeon. I know you are further North than I, the storms have passed and it actually a little brighter....Please take care of yourself and God Bless. Kimberly

Thank you for responding and I can not wait to hear the outcome. I wish you the best and keep me posted!! My BMI is low, but I have several co-mobidities....I hate the fact that the insurance co has all the control...Good luck!!

I have seen them at Sams club in Portland. I have also heard some Walmarts carry it.

I knew about the 6 month PSWLP so I started last month with my PCP. I am just hoping he is making his notes to meet Cigna's criteria. I have not sent off my paperwork as of yet. I just have my first consult with the surgeon on Tuesday, but I NEED to prepare to put my mind at ease. The one thing holding me back is my low BMI. I certainly have the co-mobidities ie: Gerd, Stress incontinence, fallen arches (I even had surgery on one foot already) high cholesterol, elevated blood pressure, herniated discs in my back, and severe joint pain in my knees. I just don't know if this will be enough for Cigna...it will be the only thing holding me back. Getting ready for an appeal is probably a self fulfilling proficy, but at least I will be ready. Thanks again. Kimberly

where do you have your fills if you have your band placed in Mexico?? Who do you go to for follow up appts??

I am setting myself up for denial as well...I am so sorry you were denied, but as other people have said....appeal appeal appeal. I haven't even submitted to the insurance co yet, but I am also preparing for an appeal so I will be ready. I have Cigna and many of the same co-mobities as you...ie: fallen arches (I have even had surgery on one foot...I would NOT recommend it) Gerd, herniated discs in my back (that I have an MRI for) severe knee and joint pain, high cholesterol, elevated blood pressure and stress incontinence. My problem is my BMI is low at this time from dieting...I just know I am the queen of yo yoing and it is already starting to come back. (gee and i thought i left it on the highway....lol) Please do not give up and trust me it is easy for me to say, but since I have put all my eggs in the "lap band" basket I will feel just like you.....God Bless Kimberly

When you say said it off "again" did you get denied the first time?? Did you have to appeal to your insurance company?? I am preparing myself for a denial so I am doing all I can to get ready for an appeal.....what did you do different the second time that you did not do the first?? Thanks for any help you can offer. Kimberly