sweetrepose

I have the option to apply for Aetna insurance that will cover 80% of the surgery and all pre & after care, however, it is through my husbands work and it will cost us out of pocket $247.00 a month just to have the insurance, so we really just wanted to sign up for a year and then cancel it. I was hoping to have the lap band within that year. It says something about a 6 month diet with a nutritionalist and I don't have that kind of time & money to waste. Isnt it enought that I have tried every other diet under the sun? Did anyone else have luck with Aetna on either not having to do the 6 month diet or at least cutting that time in half. Help!

I currently have Blue Cross Blue Shield which excludes Weight Loss surgeries, so my next option is to sign up for Aetna through my husbands insurance which says they cover Bariatric Procedures. Before we sign up which costs $200.00 out of pocket monthly, i wanted to make sure Aetna covers Lap Band. I will be calling Aetna in the next couple days to ask questions. Please see my following questions and let me know if there is anything else I should ask? q How long do I have to be on insurance before insurance will cover Lap Band? q What % will Aetna cover for Lap Band? q Does is cover pre-op (Psych testing, sleep Study?) q Does it cover follow ups-check ups? q Does it cover fills? q Lead time, what does it take to be approved for this procedure?

Ok, good! I was really worried about that! Sounds silly and I am sure you get used to what your limit is.

Ok, so if you overeat, do you throw up? I would be so scared to go out to eat and eat to much and throw up in the restaraunt. Has that happened to anyone?

Can someone give me info on Dr Fitzpatrick, like phone #, website, clinic name, anything you might have.

Think of all the future medications and doctors visits you will have to pay for if you continue to be obese, that is how I am looking at it at least. Good luck with your decision.

To those who look at their watch and see that it is 5:00 pm and have forgotten to eat because they are not hungry, isn't that a bad thing? I am not banded yet, working on it and still researching. Has anyone had any malnutrition problems by choosing the wrong things to eat? I have heard more positive things about the band than bad, but I am so scared, but yet so ready to lose weight and be healthy. My family has a history of high blood pressure and diabeties and I do not want to go there! I have high blood pressure on and off (Weird) and was on medication during my pregnancy.

After minutes of my last reply, I decided to research. Here is Dr. Tersigni website: http://www.northwestbariatricsurgery.com/html/gastric.html I just emailed them! Thanks. I would much rather have the procedure done in the states than Mexico and it would even be better in Oregon. The clinic in Portland wants to charge $19,500 INSANE!

Tracy, Thanks for the good info, do you have more info, like a phone number or website?

Stop the insanity! What are all these short terms mean???

Drewslou, Thanks for the quick reply. My questions to you would be: Did you like the facility? I noticed you had a port replacement, why? What happened? Did you like the Doctor? Where did you do your follow ups? How long did it take you from your initial contact to have the procedure? Did you have to have a sleep study, psyc test, etc? I am from Oregon, so I really only want to make 1 trip and cannot go back for fills or follow ups. What did you do?

I am one of the many who has been contiplating going to Mexico for the Lapband as insurance will not cover it. I too have heard the negative comments from friends and family when I tell them about going to Mexico. I am a little scared to go there. I am very happy for the people who have gone to Mexico and have had a wonderful experience. I would really like to stay in the US and found from a previous post about the doctor in Colorado. I am excited and have just emailed my info to them. I hope to hear back from them soon. I would like any info about this place. I live in Oregon and would not be able to do follow ups there. Has anyone else outside of Colorado gone here? Oh, and why is it that different facilities can charge such drastic differences in price? http://www.lapbandrockies.com/about-us.php

Thanks for the info Kirsten. Does anyone have info on Dr. Ortiz and his office in Mexico?

Ok, who is this Dr. Ortiz? I have seen many people on this forum that has gone to him. Is it cheaper, is that why alot of people have gone there? Is it a nice place, clean, safe and all? In Portland, Or, they want $19,500. Ouch! Of course my insurance does not cover it. YIKES.

Hi there! It is unfortunate that my insurance will not pay for the LapBand. My husband can get onto Aetna which I think it will pay 30% of the surgery, however, here in Oregon, the cost is $19,500. Does anyone know of anything on the West Coast that may be cheaper, like Washington, Idaho, California???:help:

Legacy Good Samaritan Obesity Institute may have some answers for you! You can call them at 503/413-7557. They are in Portland.

Have you gone to a Lap Band Seminar yet?

Hi there! Received my denial from Regence BlueCross BlueShield of Oregon today. Lap band is exluded in which I new! I am trying to fight it. This is a portion of the letter they wrote... We have reviewed your concerns and the information that you provided. Under your gruop contract, through (my employer), the treatment for obesity is specifically excluded from benefit payment, regardless of other medical condtions that may be related to or caused by obesity. When a service, treatment or supply is not covered, under the contract, the member.patient is financially responsible for the non-covered service. Our denial of benefits is not based on the medical appropiateness of the requested surgery; it is based on the specific limitations of your contract. You may wish to pursue alternate means of financing for this procedure. I regret that our findings could not be more positive. Let me advise you that, on a disputed determination, you are entitled to three levels of review. This grievence is the first level. You have the right to file an appeal with Regence BlueCross Blue Shield of Oregon. In case you wish to exercise your right to appeal. I have included a form for your use. Your appeal must be submitted within 180 days of this determination. In the case of an adverse benefit determination you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevent to your claim for benefits. Additionally, you have the right to file a complaints or seek assistance with the Oregon Insurance Division by calling (503)947-7984 or writing to Oregon Insurance Division Consumer Protection Unit 350 Winter Street NE, Room 440-2 Salem, OR 97310 http//www.cbs.state.or.us/external/ins Sheri Yuckert Grievance Coordinater Sooooooooooooo. What do you all think???? Do you think I am wasting my time trying to appeal it because it is excluded??? HELP! The doctors office charges $19,500 for Lap Band here in Portland Oregon. OUCH! Kathy

Hi there! Received my denial from Regence BlueCross BlueShield of Oregon today. Lap band is exluded in which I new! I am trying to fight it. This is a portion of the letter they wrote... We have reviewed your concerns and the information that you provided. Under your gruop contract, through (my employer), the treatment for obesity is specifically excluded from benefit payment, regardless of other medical condtions that may be related to or caused by obesity. When a service, treatment or supply is not covered, under the contract, the member.patient is financially responsible for the non-covered service. Our denial of benefits is not based on the medical appropiateness of the requested surgery; it is based on the specific limitations of your contract. You may wish to pursue alternate means of financing for this procedure. I regret that our findings could not be more positive. Let me advise you that, on a disputed determination, you are entitled to three levels of review. This grievence is the first level. You have the right to file an appeal with Regence BlueCross Blue Shield of Oregon. In case you wish to exercise your right to appeal. I have included a form for your use. Your appeal must be submitted within 180 days of this determination. In the case of an adverse benefit determination you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevent to your claim for benefits. Additionally, you have the right to file a complaints or seek assistance with the Oregon Insurance Division by calling (503)947-7984 or writing to Oregon Insurance Division Consumer Protection Unit 350 Winter Street NE, Room 440-2 Salem, OR 97310 http//www.cbs.state.or.us/external/ins Sheri Yuckert Grievance Coordinater Sooooooooooooo. What do you all think???? Do you think I am wasting my time trying to appeal it because it is excluded??? HELP! The doctors office charges $19,500 for Lap Band here in Portland Oregon. OUCH! Kathy

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Try Old Navy pants!!!

Hi there! I am considering the Lap Band. I have insurance with Blue Cross/Blue Shield of Oregon and I believe they do not cover it, still researching that. My husband uses my insurance, but Aetna is available to him and a spouse with a monthly fee of course. His insurance covers bariatric surgery, so I was thinking of havin my husband sign up for insurance through his work and get us covered asap. Does anyone know if there is a waiting period from the time you sign up to the time you apply to have them pay for the Lap Band???? I would love it if both insurances would cover it....