annecolorgreen

Hi-- After many years of being overweight (all my adult life), I had heard about the lap-band and thought it seemed like a viable possibility IF insurance covered it. When I checked a couple of years ago, my BMI was less than 40 and I did not have any co-morbities--yet. I feel fortunate that my BP, blood sugar levels, cholesterol, etc... are still good but NOW my BMI is 42 and I have had a reoccurrence of rheumatoid arthritis (I am only 40). Needless to say, the extra weight is not helping my joints. I have been pleased to find that this may not be such a huge problem to get approval. This forum has helped so much. I have spoke with my PCP and she seems quite willing to give me a good "letter". I go see the surgeon on August 18th...so we'll see! Thanks to everyone who has already given me so much information. I'm so thankful to have found this board! ~~anne

I spoke with my PCP and she said that if you are UNTREATED for hypothyroidism, you will be denied, even if your levels aren't perfect yet. That made sense.

I was diagnosed with hypothyroidism a couple of months ago and just saw that it can be a reason to be denied. I am on synthroid. This is frustrating to me as I was NOT hypothyroid a couple of years ago but was still morbidly obese--obviously, my thyroid is not the problem. I have heard that it can sometimes take a long time to regulate--how long? Does it sometimes regulate quickly? My TSH was 5.4. THANKS! ~~anne

Hi! Congrats on your surgery and success! I am just beginning this process. My first appointment with Dr. Lusco is August 18th and I am so excited!!! Keep us updated! ~~anne

Hi Shelly! I have an appointment with Dr. Lusco on August 18th. Hopefully, I'll find out more then about whether or not I can have sugery right away or if I have any hurdles to jump through first. I also have anthem and the doctors and hospital are "in network" although there was some initial controversy that they weren't (which has been straightened out). I actually went to the seminar last month and just now got this far! It sounds like you are doing much better with your insurance company! We'll have to keep in touch! ~~anne

I've been TRYING to go through that office and am very frustrated! I was told, at first, that my insurance had an exemption and didn't cover it (anthem blue cross). I got a copy of the benefits handbook and took it in the office and showed them and they checked again and it IS covered (with restrictions). They then told me to schedule an appointment (I've been trying for several days to get someone) and received something in the mail from "lap-band system reimbursement solutions" that says the doctors are "out of network" (Terri said they are in-network) and that we have to pay out of network rates if I'm approved. I'm frustrated. I wondered if I should speak with someone other than Terri or go somewhere else? I don't want my insurance info messed up! ~~anne

Amanda-- I had the same question! I haven't spoken yet to my PCP but my GYN said she would do it if the PCP refused. I am still trying to figure what my insurance covers and doesn't (prior to even seeing a doctor). Do you mind saying where you went and why? I went to a seminar at St. Mary's. Thanks! ~~anne