Jefe

Well, I work through a small company called the Roofing Company, and we use TFA to buy our Optima through. They told me there is definitely no coverage.

Well, Optima definitely has a written exclusion. I called and asked to be sure, and told them my doctor deemed it a medical necessity, and I was told it was still not covered. My plan is to fight it anyway. I spoke to the insurance coordinator in my office, and she told me that we can't add the rider, as it would raise the rates of 50 people, but the reseller we buy Optima through now has a person on Optima's board, and historically, this agency will fight for us when something is excluded. I'm going to go to the seminar at HR WLC next week (it look's like Dr. T's Wednesday session covers an additional procedure) and my wife may attend with me. She has a higher BMI than me, plus she is diabetic, and has High blood pressure & sleep apnea, but she is scared of the procedure. She at least has different insurance, so maybe she can get it covered.

My name is Jeff, and I just stumbled across this thread looking for info on lapbands in Hampton, VA. I have type 2 diabetes, 5 herniated disks, High blood pressure, sleep apnea, and over the last year, a plague of diabetes related boils, one of which required surgical drainage. According to an online calculator, my BMI is 47.4. I just saw my endocrinologist today, and she suggested I get a lap band. I poo-pooed the sugestion last year, but it's been a tough year. The boils are super painful, and almost constant. My sister had a traditional bypass, which scared me off, but I've been married for 9 months now, and I want a long, happy life with my wife. I have optima insurance, which has already denied me, and no chance of affording self-pay. I'm gearing up to fight them. Does anybody have some advice, and maybe contact info for Hampton Roads WLC?