phenry

I guess I should have "proof read" that before posting. I used a lot of "greats"! LOL! Maybe I should throw a wonderful in there somewhere!

I just wanted to say that I think it's great to have such a great support system out there! I have not had surgery yet, I am waiting on my insurance to see if they will approve me. But I do know that if I do get to have this surgery, it is a nice feeling to know there's a place to turn to for all my concerns and questions! You all are great!

Good luck with your approval! The waiting and wondering is tough. I have BCBS right next door in Indiana. I just found out Friday that my surgeons office faxed my paper work to the insurance company. I was a little miffed because I had asked them to wait until I had my sleep study done. If it shows apnea...that sure would help my case since it is not a "slam dunk" as they called it. Oh well...it is done and now the waiting game starts! Did any of you get a feel for what chances you have of approval from the surgeons office? I wonder if they are careful what they say as to not drum up hope.

Hi everyone...I am from New Albany area too! I just submitted all my paperwork to Dr Shina's office. I am going to call them tomorrow to see if they think I have everything I need. I have Anthem BCBS. As far as what I read of the policy, they do not require a 6 month plan, just an effort of previous weight loss attempts...so I sent in my Weight Watchers diary. If I am approved and have the surgery, I would rather have a local support group too. Surely they have something at Floyd???

I wonder if these changes in policy could help patients who are seeking bariatric surgery get approvals? There is a huge difference from policy to policy, but it still seems to always involve jumping through so many hoops. Realizing that bariatric surgery is not to be taken lightly I still believe meeting the criteria should be a simpler process.

Thanks! I will certainly keep you informed.

I just had a stress test done and although it came out pretty good...my blood pressure got high during the exercise portion. My doctor is wrote me a letter to submit to the insurance company that states I have a history of hyperlipidemia and shortness of breath under exertion. He advised me to watch my weight, reduce salt, exercise and lose weight. He says losing weight from a cardiac standpoint would be very beneficial in reducing my blood pressure. I also have a letter from my primary care physician. Her letter says I am overweight with hyperlipidemia and have shortness of breath on exertion. I also have plantar fascitis, arthritis and have had no success with diet and exercise such as Weight Watchers. I think she would benefit from Lap Band surgery. SO...I think I have what I need to submit to the insurance. I also have a copy of my food diary from Weight Watchers. The thing I didn't do was get a letter from the foot doctor. Of course If BCBS just looks at my profile and history of doc visits..they should see I have had so many visits from foot problems. Of course I am sure they want you to do all the work so they don't have to do anything! Wish me luck...I will send my packet in to the surgeons office on Monday. If they say it looks good enough to submit...I will have taken my giant step forward.

yes, I am on Zocor for the cholestrol and the hypertension was just discovered, so we are taking a dietary approach to see if it controls it. I have plantar fasiitis right now and also GERD. I am getting a letter from the Cardiologist stating my borderline condition. I agree...the more documentation the better. This will be my first attempt with the insurance company and I am really hoping for an approval. I would rather take my time and have over kill than to submit a request that will just be denied! I know what you mean about hoping the insurance co will see that it is better to treat this now than wait until something major happens. I have been overweight ALL my life...this isn't something new. Heck...why don't insurance companies at least agree to pay a percentage if they won't cover it all. That would be okay with me. Of course if they cover the whole procedure it would be nice...but I would rather they help me out some rather than to deny completely!Good luck to you too!

What do you all think about borderline hypertension along with my high cholestrol? I had a stress test on Friday and even though my heart checked out fine, the doc said I am borderline with high blood pressure. I too am under a BMI of 40. I think I am about 36.5 or something. I am gathering all my supporting documentation to hopefully get approved through BCBS HMO of Indiana.

That's great news that you will be covered! They make it sort of a bitter sweet situation it seems. It's bad you have big problems, but good that you have what it takes to be covered! It seems that this system is set up to encourage over weight people to keep on eating until they reach that magic number! I hate to say it like that, but like me for example...I have been overweight for 30+ years. I don't consider myself a huge over eater nor a huge sweet eater. It just has always been this way. I need a tool to lose weight. I have tried weight watchers...and yes...I really tried. I stuck with the plan. It helped to a degree, then it just stopped working. I continued to stay on plan, but then slowly began my regular habits because the plan was no longer working. I didn't really gain much of what I lost back...only difference...I was eating everything I wanted. No real loss or gain. Given the two choices? I chose to eat what I want. I hate to even think that I would put myself in the mindset to gorge myself on purpose so that I could gain 20 pounds and be a good candidate. I can see how desperate people would do that because the surgery is so expensive to pay out of pocket. Geeez...maybe as this surgery proves to be an effective tool for those of us who really want to get it right this time, it will perhaps someday get a little easier to obtain approval!

wow...there seems to be a huge difference from one policy to the next. I guess we all kind of know that though...it's just luck of the draw on what each particular policy will cover. I have Anthem BCBS in Indiana. My BMI is about 35.6 and I am filling out the paperwork and getting started this week with "the process". My co morbidities are high cholestral, gerd, foot problems. I feel some of those won't fly unless I have some documentation and letters from doctors stating weight loss would be highly beneficial. I am going to try to be very careful and have as much documentation as I can muster up. I know sleep apnea is a comorbidity. I think I can be tested for that as I am not sure if I have it or not. My husband would never hear me snore since he prolly snores louder than I do anyway. I do wake up quite often at night and good grief...I have to pee all night long. I am hoping I will have enough to get me covered for this.

Wow! 4 hours? I am glad you told me. They called yesterday and set me up for next week. I have asked my husband to come home from work early to watch the kids. I am supposed to receive a packet in the mail with information.

Yes...I found out yesterday that it is Mark Shina. He has a good reputation from all I have read. I am scheduled for a consult on the 13th of this month. I really like the idea you get to see and talk to the doctor without upfront fees! He does seem to be the only one doing that in this area.

I guess I will find out if there are any upfront fees once I get started after my seminar. I just don't get why you have to pay upfront money if it is covered by insurance. I am going to consult with my insurance company to see if I can avoid all that if it comes down to it. I wouldn't mind so much if I knew I would be reimbursed....but still...if it's a covered service...why pay upfront. Guess I will find out sooner or later!

Thanks Cocoa..I am reading my list of criteria that needs to be met. This came from Anthem BCBS. It states whether patient has failed conservative therapy and to outline conservative therapy. I have my weight watchers records...but I haven't attended WW since about Feb. or March 2008...hopefully too much time has not passed since I tried WW. I will see what they say if I get to talk to anyone at the seminar on the 10th.

I talked to my insurance co. on Friday. In order for them to cover anything..I need to use an in network doc. I found Dr Lusco and associates in Louisville and contacted them. First step is attending a seminar on Nov. 10th. I've already been to one, so I know what they are like unless this one is different. There is one place in Louisville called Right Weigh...they say they don't charge any up front fees if you are covered by insurance.

Hi all! I live in southern Indiana...right across the river. I am in the process of doing my research and trying to figure out who to go to and if my insurance will pay. So far I am thinking about Louisville Bariatrics where Dr Lusco and several other surgeons perform the surgery. My insurance is Anthem BCBS and they DO cover bariatric surgery including the lap band. My BMI is 35.4 so I am under the 40 that is required. They do pay for it though with other co morbidities. They say one co morbidity and I have three. Gerd, high cholesteral, and foot problems. I am so hoping I will be covered. I wanted to ask....did you have to pay upfront money before insurance kicked in? I notice some places charge 300.00 for this and 200.00 for that before you even get your surgery. That one place called RightWeigh or whatever...they say NO upfront charges...just what the insurance will pay is what they will take. But they don't mention their surgeons on their webpage. Makes me wonder if they are like a band factory where you lie on a conveyor belt and go through the banding process like branding cattle. I don't want to go to a place where I don't feel safe! Any opinions?

I am thinking seriuosly about getting the lap band. My BMI is 35.2, but I also have high cholesteral, Gerd and foot problems like plantar fasiitis and swollen tendons. All of it is from being over weight. My insurance Anthem BCBS covers bariatric surgery with a BMI of 40 or above...or 35 with at least one co-moribity. Anyone out there have any idea of my chances of approval? Oh...I was on weight watchers earlier this year and the latter part of last year too. I am hoping I have the criteria needed mostly covered.

how much does Dr curry charge for fills? Does he use flouro? (sp)

Can anyone tell me how much Dr Curry charges for self pay lap band surgery? It's not so much that I am bargain shopping because I am not, I just need to know what I would be looking at as far as cost. Thanks!

That's great news Chris! I don't have a band yet...I am still researching. I am hoping to make a decision soon. I am thinking about going with Dr. Curry in Cincinatti. He has such a great reputation and I am definately looking for a quality doc.

I hate to say hello Mommy...just seems funny! How about Merri? LOL! Where is Merriville? I am near Louisville...down in the south east part

Hi Brandi! I am close to the river to...just a little more south, closer to Louisville. I am still tossing it around as far as having surgery. Just about the time I decide, something comes along to change my mind! Like reading about MGB surgery. It costs more, but sounds like it is easier to adjust to. Not as popular yet as lapband...but I wonder if it may be easier on the body and easier to adapt to. Guess I have tons more research to do!

So who did your MGB and how did it compare price wise to the lapband? I am not banded, but I am considering it. Maybe I should look in to this MGB more before I decide!