higgikd1

11/05/2010 Well, it's official...Cigna denied my request for lapband and even has a "No Appeal" process in place. What a bummer! I expected them to say no, but I thought I would just keep appealing. Would love to know if anyone else had this problem with "No Appeal" and if you were able to get them to overturn it. :cursing:

Hi, there! I, too am fighting with Cigna. My husband is a nurse at a local hospital chain here in Tucson, and Cigna policy specifically states that lapband and ANY type of weight loss program is NOT covered. They just denied me, even though I have met ALL the requirements, done all the preop "hoop jumping". To add insult to injury, they also state that they have a NO APPEAL PROCESS. I don't like to take No for an answer, so I am doing my homework on the cost for overweight healthcare workers just to add to my letter to see if that might shake them up. Doubt it, but everything is worth a try. Good luck to you. :eek:

10/17/2010 Well I am now officially getting bummed about not hearing ANYTHING from the hospital where I saw the MD, did the psych eval, saw the nutritionist x 2, have called 3 times, e-mailed them 2 times and NOTHING!!! I have decided not to get super discouraged, but find myself not wanting to write in my food journal consistently, "thinking" about exercising now, and in general, just feeling kind of discouraged. I know from the other blogs, etc. that sometimes it can take a LOOOOOOONG time for this to happen, but would really like some sort of response from Cigna and/or the hospital. Will keep "shaking the tree" until I hear. :thumbup:

Hi! I live in Tucson, AZ and Dr. Carlos Galvani is here at the University of Arizona doing the lapband surgery. I liked him when I met him for my initial consult and have gone through all the "hoop jumping" of nutritional counseling, psychological testing, etc. but have heard NOTHING from the clinic. I have called and left 3 messages, but I am really expecting a fight from CIGNA insurance because of a clause which specifically states that no employees or their families can have any kind of treatment pertaining to obesity...Isn't that unfair? Good luck to you.

Hi! I just heard about this hypnosis therapy versus lapband myself today and am wondering about it. I have been "pretending" I have already had the surgery for about the last month and have actually changed some of my eating behaviors (i.e. smaller plate, baby utensils, writing food down in a diary, exercising, etc.) and have lost some weight. I am pretty sure my insurance will deny me at least once, so I guess perhaps I am "gearing up" in case they deny me totally. What do bandsters think about this hypnosis therapy?:drool:

09/27/2010 Well, I am now officially in the "waiting stage" to see I insurance will really approve me. It seems SO SLOW!!! I called Melissa at my surgeon's office and she said she would get all the paperwork in, but that was 2 weeks ago. I know these things take time, but in the meantime, I am still "pretending" that I already got the lapband and am still writing food down in my diary, eating off smaller plates with baby utensils, and have lost well over 10 pounds in the process. However, I would really like to just get approved and get on with it. The other blogger's stories of their waits, etc. have really been helpful for me. Trying to stay pro-active!:smile:

09/08/2010 Wow! Today I saw the nutritionist for the second time. Saw her 2 weeks ago and she gave me some great info. I have been writing down everything I eat (gulp!) and making myself get a little bit of exercise by walking around my neighborhood for 15-20 mins. Well, guess what? I actually lost 10 pounds just by doing that for 2 weeks. I told her that I was a "professional weight loser", just don't seem to be able to keep it off. The more I investigate this whole lapband thing, the more I desperately want it and KNOW that it is the right thing for me. I will keep you posted on my fight with the insurance company to get this surgery. I told them I even wanted to be the spokesperson for this hospital's bariatric surgery center. :wink:

I have just started eating oatmeal and before I just could NOT believe that one of those little packets was ACTUALLY a serving!! (Ha!). Now I make it in a little bowl and eat it with my tiny sterling silver baby spoon and chew, chew, chew. Stays with me for a loooooong time.

08/29/2010 OK, so I AM SO IMPRESSED WITH MYSELF!!! I have been keeping a food log/diary to take back to the nutritionist, AND (get this!), I just came back from a 20 minute brisk walk around my neighborhood!!!! I can't remember the last time I did ANY type of actual exercise that wasn't house work or gardening or moving furniture!!! I am really using this time to get ready for the lapband and am just determined that Cigna WILL approve me. :scared2:

Hey, all! I went for a plastic surgery consultation a few years ago (was still fat then, too!), but for the cost, I decided to restore an old MGB that I had stored for 20+ years. Will STILL get the plastic surgery done eventually and am all in favor of "better living through surgery..." if it is what someone wants and can afford. :thumbup:

Hey, everyone! Lovin' the fact that those of us "Over 50" have such a cool group. Count me in! I am pre-op, having just had the (I hope) last of the steps I need to take before praying that Cigna approves me. I will keep you all posted.

Bklynike - Working with the public is one of THE most stressful things a person can do! I think your insight into what the old you would have done (eat over it), versus what the new you does is just like money in the bank. With the skills you have learned interacting with the public, I can't imagine that you couldn't get a MUCH better job where folks actually APPRECIATE you! Keep you chin up and remember, most folks who are raging at you are really raging at a ton of other things BUT YOU...you just get to hear it!

08/25/2010 OK...Today I met with this very nice nutritionist at UMC Hospital and really enjoyed my interaction with her. "Stephanie" was pretty knowledgeable about the lapband diet, pre-op, surgery, etc. even though this is a fairly new surgery for UMC. I have already been doing some of the pre-pre-op things such as eating with a smaller plate, watching alcohol consumption, using a baby spoon, actually measuring portions. All of this has been such an eye opener for me. If I could do all these things all the time, I wouldn't even NEED the lapband, but although I consider myself somewhat of a "professional dieter" after 30 years of being obese, I can get it off, just can't seem to KEEP it off. I am still feeling like luck is on my side and that although my Cigna has this stupid clause excluding CHN employees and their spouses (sheesh!), perhaps I will be that one that they just have to authorize. You know...Squeaky Wheel Syndrome!!!!:wub:

Hi, J-BandRanger and sandradee0124 - Thanks for looking at my blog and commenting. CHN is my husband's employer (Carondelet Health Network) and yes, it really does EXCLUDE their employees and spouses from the lapband surgery. However, CHN lost their bariatric surgeon, after spending tons of money on equipment, etc., and then he left to go to a competing hospital. So...with that said, I am hoping maybe by having to go outside the network, they just might approve me. Had the nutritional eval today so am keeping everything crossed! Thanks for the vote of confidence.

08/22/2010 Wow! I went to my Ob/Gyn last week and had actually lost 10 pounds just in anticipation of the lapband. I have less trouble losing weight than keeping it off and am actually worried I might lose too much weight and get too low a BMI! That may be a first for me. I still expect quite a fight from Cigna, as they do have this exclusionary clause in the policy that I have saying no CHN employee or their family members can have bariatric surgery, but I have to believe that the surgeon I went to would not let it go as far as it has just to be turned down. I definitely have some co-morbid conditions in addition to the greater than 40 BMI; I am being treated for hypothyroidsm, hypertension, have crummy joints, and take an anti-depressive. Shouldn't these count for something?????:biggrin:

08/11/2010 Well, I had my psychological interview today. Wow! It was pretty extensive! Had to fill out the MMPI (Minnesota Multiphasic Inquiry), which fortunately I have done before so it was not overwhelming, and another one from Quest, I think it was. Well, I spent some time with a lovely woman psychologist/psychiatrist who asked me some pretty basic questions; Have you tried other means of weight loss (duh!), what were they, questions about exercise, etc. I left stating that I really want this surgery and hope that I am approved. I have Cigna insurance and they are famous for turning down our local hospital's employees and their families, but I am feeling like everyone I talk to feels I know what I am doing and know that I am sincere in this endeavor. I will keep you posted!

08/09/2010 Well, just got back from the road trip to Kansas. Had a terrific time seeing family, looking at land, and going to my 40th high school reunion. It was actually only my 39th, but the school was so small, they combined the class of '70 and '71. Some of us even went to grade school together. I had some mild trepidation about going, as I have gained SOOOOOOO much weight since high school, but I must say I had a terrific time nonetheless. I kept thinking, "Gosh...I wish I could get approved soon for that darned lapband!". Have my nutrition and psychology appointments this week (Wednesday, August 11th), so will write more after that. Keep everything crossed for me!:thumbup:

I really think I will be approved thru Cigna here in the US, but have also investigated lapband in other countries. I am wondering if a lapband is performed outside the US, how does one then get fills? I can't believe a physician would want the liability of doing fills on a band he/she did not install. Any thoughts/info on this?:biggrin:

07/24/2010 Today my husband and I were supposed to go on our road trip to Kansas, but first the solenoid went out on the drip system, then the pool pump died. Gad! Is this a sign, or what? I think normally I would have gotten all stressed out about it, but I just took it in stride and worked for 4-5 hours at home and we will just leave tomorrow. I am sure in the past I would have used this as an excuse to overeat or over drink something, but I am getting myself "psyched" up to have the lapband and to use the skills I am learning from everyone on the lapbandtalk.com. Thanks, all, whomever you are!!!

Hi, all! I was listening to NPR yesterday, here in Tucson, AZ and heard about Americans going abroad for lap band. Anyone know of this having been done in London or thereabouts, and did US insurance pay for it? How do fills happen? Can they be done in the US with a physician who did NOT perform the band?:biggrin:

07/20/2010 I am enjoying the small changes I have made in my eating just since meeting with the surgeon. My appointment is set for the psychologist in August (11th), and will get the appointment with the nutritionist when I return from Kansas for 2 weeks. I have been making myself eat with a baby spoon, chew everything 15-30 times (gad!)...have you ever tried to chew cottage cheese 30 times? I am not drinking alcohol (usually have wine at dinner) just to shrink the old liver for surgery. I keep visiting the chat rooms on lapbandtalk.com to see what others are or have experienced. I can already visualize myself as thin again.

Thanks to all who commented on my blog. I had to go have a minor procedure today and found I had actually lost 4 pounds since I met with the bariatric surgeon, just in my excitement to have this band done. I now officially have my psychologist appointment and nutrition appointment. Wow! There is some value in not taking no for an answer, huh?

07/17/2010 I received the "Lap Band Companion" book in the mail yesterday afternoon and have already read ALL of it, as well as re-reading other parts of it. I have decided to "pretend" I have either already been approved by Cigna for the surgery, or that I am post banding, which means I am trying to measure food, chew 30 times, not consume water 30 mins to 1 hr. before meals, etc. Hopefully, I can shape my own behavior so that WHEN I am approved (how's THAT for optimism?), I will be that much farther along. More later...

Bklynike - Thanks for the encouragement. I really know I can do this. I always can GET the weight off, just don't seem able to KEEP it off. I feel this is the last weight loss event I will need to do, and just learn to have a new/different relationship with food from band on out...