wantlapband

When do you think I should start calling the insurance company to see if they have any paperwork on my surgery? Should I bug them? It's only been 2 weeks (I think) since I first met with the surgeon. I already have my pre-op visits arranged and my surgery date on Sept. 20th..

Anyone with a low BMI, lower than 40, but between 35-40 get approved from their insurance company?

Em1125 Did you go through all your pre-op visits? If you did, did the insurance company cover them then not approve your surgery? I have all my appts set up for pre-op testing. I wonder if they will approve them? I hate insurance companies..we pay so much for insurance as it is.. it's crazy.

I don't have any money for self pay or any money to even get to mexico...

oh that is wonderful! What a great husband.

I get DVT rare ones in my upper extremity and superior vena cava syndrome....I've had five angioplasties but no luck getting through my veins..totally occluded. I was on coumadin (20 mgs a day) then I became allergic too it, so I'm back on lovenox, which I hate so much! I have to be on it for the rest of my life. Wow you have a great surgeon!!! I hope you get approved after the appeal. You deserve it sooo much! Keep us all posted.

em1125 did you meet with the surgeon that was actually going to do the procedure on you or just his/her assistant? I met with the surgeon who will be doing the procedure if my insurance approves it. My BMI is 35.3...I gained a whole 1 1/2 pounds before I weighed in..didn't bump me too much...lol I hope when the surgeon says "You'll be approved" he means it...its crazy to get all excited then have your heart broken. I'm so afraid of that. I was sooo happy after meeting with him. He of course has to work with my cardiologist because of my blood thinners, they want to make sure if I go off of them 3 days before surgery that I won't get another DVT. Its a pretty tricky situation for me. I had to go off of them before when I had surgery on my wrist..I started to swell up fast. I'm one of those rare people...whatever rare happens in a procedure its me who will get it.. I'm keeping my fingers crossed for you.

Hello, I met with the surgeon who is actually going to do the procedure on me. He is the director of it all. Is that good that I met with the surgeon? Does that mean he will make sure that I am approved?? He made it seem that way...when he gave the paperwork to his assistant to write up all my appts, he mentioned to her heart disease, sleep apnea, RA, GERD, vascular problems...I hope this goes through. I'm set up for all my appts, pschy, nutri, upper GI test, anesthia (sp), and then another appt with him. What are your thoughts?

does anyone have bcbs of new England (MA)...... how are they???? Have your letters come from your pcp or the bariatric surgeron that is going to do your surgery? Do the insurance companies listen to the surgeon that is going to do the surgery or do they go outside and get another bariatric surgeon look at the paperwork without even getting to see the patient in person? From paper what the heck can they tell or see??? Just wondering how it works.

did you have alot of information documented about your health issues? I have a hugh 1 foot file I think on me at brigham and womens. Maybe I should have worn weights now just to make it to the 40 mark :scared:

I'm so sorry to hear that...that is so aweful. I'm fearing the same here. I hate insurance companies. You have to be on your death bed sometimes before they approve anything, and if your lucky

oh yeah...the PA i met with yesterday told me that she tells people with no health issues with a low BMI to actually gane weight..and that is coming from a doctors office!

Oh that is sad. That is what I am afraid of....I went yesterday, I'm going to brigham and womens in Boston...I have BCBS of MA. The doctor told me that I shouldn't have a problem. He circled all the co-morbities..the big one is heart disease. With me everything is documented....my insurance approved xenical for 3 months but it did not work. Everything kind of surgery, angioplasty, ultrasounds, MRI's, catscans I have had over the course of 6 years is documented. I have had SVC syndrome, which I get from lying down flat...so he is using that as heart disease..i have other things going on, DVT's, chronic venus insufficiency (Which I am able to be on disablity for.) But its heartbreaking..i hope I don't be disappointed.

Did anyone's doctors told them they shouldn't have a problem with their insurance company to get approved? Or is this the standard line they say?

its sad what we have to do huh? I was thinking about that yesterday when I went for my first visit. I was too afraid though of getting caught, then I went there and I got weighed with all my clothes on, so I could have done it easily. Damn huh? My BMI is 35.2, but I have co-morbities, but still if I could have just brought my weight up 25 more lbs...then I would have the magic number 40.

Hey!!! I am soo happy for you!!! You have to tell me everything after you have surgery. When do you go on your liquid diet?

hey time to love me, I just got home a little while ago..guess what? The surgeon said YES! I have a surgery date of September 20th, but I still have to wait for the insurance approval. He doesn't think there will be a problem. He wrote down heart disease, sleep apnea, high cholosteral, I think high blood pressure...I'm so excited!!! I go back in August to see nutr. and to get an upper GI. I had one a year ago, but he wants me to get another one to make sure I don't have anything else going on because of my GERD. Did you hear anything? Your date is coming up. Does the waiting seem long to you? My cardiologist called me and I am going to be a study for a new blood thinner, why not. Its a shot still but its not suppose to sting as much as the Lovenox I take. After the surgery, they just have to watch me closely because I have to go off my blood thinners 3 days prior to surgery, then they have to administer them right away after surgery. I'm SOOOO Happy!!! I the insurance company doesn't let me down.

Andrea, Thank you for the bright look for us lightweights, I was extremely happy to read your post! i am going to the surgeon today! I'll post more later as to what he has to say. your doing excellent at your weight loss!!

Hi, I am in the same boat as you! I am at 205 lbs with a BMI of 35.2. I am researched this and went to a seminar. I really want this surgery. I have been struggling with this for 8+ years now. EVERYONE asks me when I'm due...lol..not really funny, but a few months ago someone asked me and I said "I'm not pregnant I'm FAT"...I go to see the surgeon tomorrow about it. I'll let you know..

hi time to love me, I am going to Brigham and Womens. I have the appt tomorrow. I see my cardiologist today down there, so I will talk to him more about it and find out what he will write with the doctor, he only wanted me to see this doctor. He actually told me when I asked him about the surgery 3 months ago (I wanted to have approval from him first, since he knows my body) and he said "this would be a good thing for you". So, the surgeon should set the date for me tomorrow? Should I ask him too? Do they weigh you with clothes and shoes on? I have always been weighed like that. I'll get weighed today by my doctor, I don't have a scale at home. If I have surgery, you better believe I will one :grouphug:. What kind of questions do the surgeons ask you? What kind of information do you ask him besides about the procedure? Do they send in the paper work right away? Did you bring any paper work with you to the first visit? Is there more than once initial visit with the surgeon? Thanks!!

My PCP said she will write the letters necessary for the surgery to send into the insurance company. She'll write whatever the surgeon wants her to write. What does the surgeon require from paperwork. Does he want you whole medical file? Mine is so THICK at Brigham & Womens, he is at B&W. I know they can look stuff up. I have an appt with my psych doctor on the 17th anyways for a med checkup, at that time, I am going to ask him for the weight loss stuff he has to do on me. I have met with so many nutri in the past, do I have to meet with them again? Its such a waste of time, at least to me. I'm a lightweight at 205, 35.3 but I think I still deserve to have surgery and finally get a chance at being happy once again and being able to do things with my family again. :grouphug: I'm so sad and scared about my appt tomorrow with the surgeon.

You nailed it. I am 85 lbs over weight and have been for years. My BMI is lower but still 35, I should still qualify. Its not fair.

The reason I asked was because I am 205, BMI 35.3 and I have some co-morbities and I really would like to have lap band surgery. I've researched it for a long time. My weight just keeps going up. 205 might not sound alot to some people, but to me, its a burden on my life. I am not as healthy as I once was. I miss being at 115-120 lbs. I think I deserve to have a chance at having lap band surgery done. I am still obese. If you put me next to a someone who weighs 300 I might look skinny to them, but i'm not. I'm just saying I guess lightweights as myself with health issues should get a chance. If I don't have surgery I know I will get depressed, I already am due to my weight, but I will def. get worse. I am not one of those women who just want it to and expect everything to be okay. I know it will be alot of work and a lifestyle change. I am prepared for that. My husband is prepared for that. It would actually be the best thing for this family as everyone will be eating smarter. I go on thursday to see the surgeon. I'm scared he will say no. I see my cardiologist today, I will talk to him more about it, he is 100% for it and suggested I see only this one surgeon for it. I have BCBS of MA. All my records state how I have tried to lose weight, so that is good. I am on xenical now (the insurance company approved it) but I have not lost any weight. Per the insurance company I am suppose to lose 12 lbs in 3 months. Well its almost 3 months and I have lost nothing, actually gained a lb. I have cried to my PCP and therapist many times about my weight. They know my struggles. I know I gained a bunch of weight after my mom passed away suddenly 3 years ago of a heart attach, she was 59. Wish me luck!

time to love me Did you get approved yet? Did you say you have BCBS of MA? Where are you going for your surgery. Thanks

This is to anyone: Suppose your BMI was 40, you weigh 250 lbs., you get approved, have the surgery. Now your down to 205 lbs and your BMI is 35.5. What if you had to get rid of your lap band at 205 lbs. Would you be happy at 205 lbs? Would it be a struggle for you to lose weight without the help from the band? What if you had to start all over again for approval being at 205. What would you do? Just wondering..