gabi311b

I am so sick of Kaiser's s***. I am 5'8'' and my BMI is 38.8. The saddest part is that if I were to gain 20 more pounds I would qualify for the surgery. I HAVE TO GET FATTER TO GET SKINNIER!!! Isn't that unfathomable? I have decided that I am going to switch insurances for sure and then from there see if Aetna will cover with no co-morbidities or I will take out a loan and self pay. I am so frustrated with all the if's and maybe's and we'll see's...I want a definitive answer and I am being so impatient!!! I know I shouldn't be like that but it is so hard when everything I have done has just made me hit walls. It sucks... AGHHHHHHHHHHHHHHHHH :tt2::cursing::smile2::cursing::thumbup::cursing::smile2::cursing::scared2::bored::scared2::tt2::scared2::tt2:

Hi di1138, did your insurance cover the procedure or were you a self-pay? I am trying to weight (no pun intended) all my options becuase I don't know if I will qualify for insurance coverage and B.H. Physicians is like 16k. Let me know...thanks!

I am so sorry that this has happened to you. I say stick with it...you have already seen such success. Everything will work out, I'm sure! I will keep my fingers crossed for you.

So, it looks as if I am going to most likely be self-paying for the lap band procedure and I am wondering if anyone has ever been to or heard of B.H. Physicians... I live in the Los Angeles area and am looking for some suggestions on doctors, hospitals, etc. Any help would be great! :thumbup:

Yeah she said I don't qualify for the program. She said that Kaiser does offer the lap band through the So.Cal insurance but they just started and you have to go to all those classes. I was so bummed when she said that I didn't even ask what the qualifications were. She gave me all these suggestions like...try overeaters anonymous, food addicts classes, exercise more/eat less. All that bs that I've already tried. She also offered some basic weight management classes that Kaiser offers but again I would have to go to those other locations. I'm so confused, I don't know where to go next. I don't know if I should switch insurances and see if I'm covered or if I should just look into self pay...grrrrrrr

Haha, my appointment didn't go as well. My doctor said that I don't qualify for the referral at all. She said even if I did Kaiser requires like 50 weeks of a weight management class (only offered in Panorama City or South Bay) and if you miss one then you are out of the program. It is pretty apparent to me that I need to switch insurances or pay for this out of pocket. I ONLY weighed in at 252lbs and that wasn't FAT ENOUGH...are you kidding me? It made me sick... I really hope your appointment with the bariatric dept goes well and I hope we can keep in touch and track each others progress. Gabi

How did it go? I'm going this afternoon and I'm going to ask about the band as well. I go to the Kaiser clinic on Lake...we will see. When they say get records do they mean that you have to have a BMI of 35+ for 5 years or more of just a history of being overweight?

I am wondering if your insurance covered your surgery or if you had to pay our of pocket. The reason I ask is that your starting weight is less than mine by about 20 lbs and my insurance won't cover me right now because my BMI is still too low. Can you give some advice?

Boopie, you live in Pasadena, what part??? Wow, what a small world. Yeah I transferred from Kaiser Nor Cal last year and apparently they cover it. I don't know why the two are so different...seems a little strange to me. When we do switch insurances how do we get our files from Kaiser...? I have never seen my file so honestly I don't even know what is in there. I have had them my whole life but for 25 years I had Kaiser Northern CA. I'm confused!

jmegirl, Do you live in Colorado or will this be a trip for you to go to this dr.? I am so nervous about my drs appointment tomorrow because I am afraid they are going to say that I don't qualify. I have no "diagnosed" comorbidities, but I have documented high bp and prediabetes. They didn't ever give me meds for them though. Is it sad that I did the calculation and it would only take an additional 20lbs to get me to a 40+ BMI. Who was your insurance through...I hope not Aetna PPO. Good luck on your surgery, I bet you are soooo excited! Keep me posted on how everything goes. Gabi

Kaiser So Cal does not cover it yet. I have heard that Kaiser Nor Cal does but for some reason the two don't talk the same language. I will be switching to Aetna during open enrollment. I would go to your potential new insurance website and look up their policy specs. I have noticed that for the most part the general requirements are similar, but not exact. I have my dr. appt with my Kaiser doctor this friday and I'm really nervous! I don't know if I can start the dr. diet now and have it count when I actually switch or not...cross your fingers for me.

I am getting ready to switch my insurance to Aetna due to my job eliminating the policy that I currently have. I have a BMI of almost 38 and I am 245lbs. I have never been 'diagnosed' per se (with perscriptions) for high blood pressure, prediabetes or acid reflux but the past 5-6 times I have gone to the dr. they have told me that i need to lose weight cause my blood pressure is too high and my sugars are too high. At what point are you considered to have co-morbidities and they will look at those? I have tried everything in the book to lose weight and it just doesn't work. I have done food journals, personal trainers, NutriSystem, Weight Watchers, dr. supervised pill diets, etc. I am meeting with my dr. this friday but it's still going to be under my current insurance until January 1. I would like to get going on the pre-op stuff ASAP but I am so afraid to get excited about this if I am just going to be shot down by the insurance. Does anyone have any suggestions?

I am interested in getting the Lap Band done and have not even approached my doctor yet. I do have an appointment next week. I am 26 years old, 5'8'' and 245lbs. I have had issues with acid refulx, high blood pressure and borderline diabetes. My BMI currently is about 38. My biggest fear is to get excited about this tool that will be so beneficial to me then come to find out that I don't even qualify for it. What is the first step when considering this type of surgery? Does anyone have any tips on insurance coverage (I currently have kaiser so.cal and am thinking about switching to Aetna)? Has anyone had this surgery with Aetna insurance? I am also wondering about hospitals, after surgery diet, recovery time, etc. Any help would be wonderful! Gabi

Has anyone heard if Kaiser Southern CA does lap band surgery? I am interested in getting the lapband done and have not even approached my doctor yet. I am 26 years old, 5'8'' and 245lbs. I have had issues with acid refulx, high blood pressure and borderline diabetes. My BMI currently is about 38. I also have the open enrollment for my job coming up where I can switch insurances and my other choice is Aetna. Has anyone had any experience with that? My biggest fear is to get excited about this tool that will be so beneficial to me then come to find out that I don't even qualify for it. Any help would be great!