PugMaster

Tia, Truly sorry if I offended you. The "Duh!" was a commentary to myself on the obviousness of what I wrote...as in "I can't believe I just wrote that! Of course you have to do what they require!" It had nothing to do with you. Next time I get the urge to critique my own writing, I'll just backspace and start over. Good luck!

Tia, The thing with Aetna seems to be to make sure that you do everything they require. Duh! You need to take a look at their Clinical Policy Bulletin #0157. It spells out pretty clearly the "Selection Criteria" (i.e., the hoops you have to jump through) for bariatric surgery. I read it and figured out what I needed to do to qualify in the shortest possible time. Unless you have 6 months of physician supervised diet in the last 2 years (I did not), I don't see how you can qualify in less than 3 month.

I have Aetna and I found them very easy to work with. I called them and made sure that my company's coverage included the Lap-Band (Aetna has been covering it since the end of March but not all employers allow it). I then began a 3-month multi-disciplinary program supervised by my PCP and a registered dietician (all covered by Aetna except for copays) while I searched for a surgeon. I selected a surgeon about 2 weeks before I completed the multi-disciplinary program and his office coordinated with my PCP from that point forward. The surgeon's office requested approval; my PCP forwarded all of my records to the surgeon who forwarded them to Aetna. Aetna came back with one question and approved me within a week. I had surgery 2 weeks later. Aetna did not cover the psych evaluation required by my surgeon ($1000). My surgeon is not in network so he will bill me for some portion of his $5,000 fee. The hospital ($10,000) was covered completely. I suspect that I will be out of pocket about $3500 when all is said and done. I would have paid myself otherwise so its still a great deal as far as I am concernced.

Haven't tried Protica but I have tried the IDS New Whey 25 gram Protein Bullets which seem to be pretty much the same thing. I got them just in case I had difficulty swallowing after surgery. I had no problem but I tried them anyway. They are not particularly tasty but they do provide 25 grams of protein in 2.9 ounces. I prefer my shakes.

I was banded last Friday, the 13th of October. By 3:00 in the afternoon I felt great and was ready to go home but they made me stay overnight because I have apnea. Checked out of the hospital at 9:30 Saturday morning and after a 3-hour ride I was sitting at my son's football game by 1:00. Rode home that same evening. I have had no problems with pain, nausea or swallowing. I went back to work on Monday. I'm sticking to my doctor's orders for 2 weeks of liquids (followed by 2 weeks of mushies) and have not had any problems with hunger. So far, it's been pretty easy.

I have Aetna. I did their 3 month multi-disciplinary program with my PCP and a registered dietician while searching for a surgeon. My surgeon submitted the paperwork to Aetna and they approved me for the Lap-Band within a week. The whole process will be about 15 weeks beginning to end and I have had Aetna for only 6 months. Every company's plan is different but I would not dismiss Aetna out of hand.

Hi momsue, Dr. Pinnar's website is http://www.pinnarsurgical.com. The next seminar is on September 6th. You need to make a reservation. My insurance is Aetna Choice POS II. Aetna started covering the LAP-BAND in March of this year. Don't worry about being too nosy. Questions are good. Answers might be bad but questions are good.

Hello everyone. I have been researching LAP-BAND surgery for longer than I care to admit (would you believe nearly two years). This is my first post. About three months ago I decided it was time to get off my over-sized posterior and take action. With the full support of my PCP I started the 3-month multi-disciplinary program required by my insurance company. I continued to research local surgeons and narrowed my choice to Dr. Michael Schweitzer in Baltimore and Dr. Eric Pinnar in Reston. I attended Drs. (Dr. Eric practices with his father, Robert) Pinnar’s seminar last Tuesday evening and I had my consultation with the program director and with Dr. Eric last Thursday. The seminar lasted more than two and a half hours and covered every aspect of the surgery. Given all the research I had done, I didn’t learn very much about the surgery, itself, but the seminar was very, very thorough and well done. Most importantly from my perspective, the doctor, his staff and three of his patients described in detail the extensive pre-operative, after-care and continuing support that, in their minds, is the key to success with the LAP-BAND. Frankly, I had never thought that much about after-care. I knew I would need to have fills but the importance of full-fledged after-care and continuing support had escaped me. The program director, Sue, and Dr. Eric also emphasized the importance of the program, not the surgery, during the almost two hours I spent with them for the initial consultation. I can’t even begin to describe how impressed I was with Dr. Eric, his staff, his concern for his patients as people, his commitment to the LAP-BAND and his program. He made my decision an easy one: on Friday, I cancelled my appointment for an initial consultation with Dr. Schweitzer. So my journey begins. Next week I start the psychological evaluation and other testing Dr. Eric requires of all patients. I will keep you posted on my progress. Please keep a good thought.