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Big decision -- please help.



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I am scheduled for surgery 7/14/11. It will be self pay. However, I just found out I have high cholesterol so my insurance MAY pay for it. Unfortunately, if I go the insurance route, I would need to fill out tons of paperwork and wait at least 6 months before having surgery. Do I put everything on hold and wait to see if insurance will cover it or do I go forward with my plan and have surgery 7/14/11? My cost is going to be $8500. I'm using my IRA money to pay for it.

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I would say go ahead and do it on 7/14, if you wait 6 more months your cholestrol may get worse and be harder to control in the long run...

I already 2 months into my journey for the lap band and I have to wait around 6 months too, if I had the option of self pay I would get the band asap!

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Go for it! Insurance is a pain in the a**!

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Wow... only one right answer in my book (unless you have lots of extra money laying around) INSURANCE.

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Your post it haunting me.... LOL!

It took 2 weeks for my insurance to approve me, it was a piece of cake. My only co-morbid was High Colesterol.

I think you should try your insurance, $8500 is a lot of money. Even if it takes 6 months.

I can't imagine spending the 8500.00 if you can get your insurance to pay for it, little lone pulling it out of your retirement which will cost you 10% penalty and 28% income tax. That's almost $12000.00

Ultimately, it's your decision. Good Luck

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I am scheduled for surgery 7/14/11. It will be self pay. However, I just found out I have high cholesterol so my insurance MAY pay for it. Unfortunately, if I go the insurance route, I would need to fill out tons of paperwork and wait at least 6 months before having surgery. Do I put everything on hold and wait to see if insurance will cover it or do I go forward with my plan and have surgery 7/14/11? My cost is going to be $8500. I'm using my IRA money to pay for it.

Hello there,i just had my surgery today and i started my journey in Oct 2010,I would definanty see if your insurance would pay.I was denied by my insurance I appealed it and was approved On April 19th it does take time,but at least give it a shot.It is worth it!!!!~good luck!

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I would research the track record of your insurance. Do they usually pay on one co morbidity or do they put people through a lot of hoops and denials? Also, are you fairly sure you will have the same policy in one year? Is your company due to renegotiate their policies soon? If so, they might change their coverage. Here in Texas teacher insurance, they re stated the policy waiting period in April and it anyone who didn't start the process by then would fall under the new policy in August, which requires more money up front and the teachers might as well go self pay. Just saying, research it all then make the decision.

We're here for whatever your decision is.

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Definitely try through insurance. I just don't see a good reason not to.

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Honestly, if I have to wait or go through a lot of insurance hassle, I'll probably not do it. Does that mean I shouldn't be doing this now? I had everything planned for having the surgery now. I'm having a tough time accepting that I might not have the surgery. I'm so confused -- and a ilttle sad. I really wanted this to happen now.

Definitely try through insurance. I just don't see a good reason not to.

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I recently had the surgery about a month ago. I would say it depends on your financial status, however, times are tuff even if you are financially well off. I would say wait for the insurance. If all you have to do is fill a couple of forms in order to save your self 1K or more, this option would be best. In regards to time, you've waited all your life thus far..... 6 more months is not that long especially if the benefit is not having to take any money from your IRA which you will need in the future. At the end of the day you have to choose whats best, but I would wait! :D

I am scheduled for surgery 7/14/11. It will be self pay. However, I just found out I have high cholesterol so my insurance MAY pay for it. Unfortunately, if I go the insurance route, I would need to fill out tons of paperwork and wait at least 6 months before having surgery. Do I put everything on hold and wait to see if insurance will cover it or do I go forward with my plan and have surgery 7/14/11? My cost is going to be $8500. I'm using my IRA money to pay for it.

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It's tough to wait when you have made the mental decision but it really comes down to your personal situation and only you know those details. Good luck with whatever decision you make.

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I would check the stats of your insurance company - see if your Dr. will send in for a pre determination of beneifts - I went thru the 3 month wait with my insurance company to be told BCBS changed to a 6 month wait AND after another 4 weeks of fighhting back and forth with the insurance company p Bariatric Surgery was NOT covered at all only complications that may arise during surgery. I ended up self pay - well worth it~~~ But if my insurance would have said yes they will pay Although I was very anxious to get the band I would have waited .. If you take the money from yoru 401K you will be actually paying yourself back including any interest they charge..better than a bank loan :unsure: Good luck

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I am scheduled for surgery 7/14/11. It will be self pay. However, I just found out I have high cholesterol so my insurance MAY pay for it. Unfortunately, if I go the insurance route, I would need to fill out tons of paperwork and wait at least 6 months before having surgery. Do I put everything on hold and wait to see if insurance will cover it or do I go forward with my plan and have surgery 7/14/11? My cost is going to be $8500. I'm using my IRA money to pay for it.

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Hello, researching your ins. would be the best thing to do. I can hardly wait for a surgery date, but my ins. required a year with a life coach. My year will be up Aug. 16th. It's been hard, but I've been pretty patient. In the beginning I was just mad, but the time has gone by so fast. I've learned a lot of good things with my life coach and gained a new friend as well. $8,500 is a lot of money--especially using your IRA money. If you decide to go with the ins., please let me know. I'll be there for you through the wait!

:)

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I hope I dont sound too negative, but if you dont have the motivation , comittment, and determination to make this happen with a bit of a delay (and save some money you might use later for plastic surgery or a well-deserved post-weight loss vacation) you are not likely to succeed with the lapband.The lap band is not for an instant gratification type of person, it is a lifelong change in everything you do...I self payed because the only way I could get covered was to GAIN 20 pounds which I could not do but I could afford it. The challenge of all the BS involved with insurance is just part of the road and in a way its like a test of your comittment...good luck!

Honestly, if I have to wait or go through a lot of insurance hassle, I'll probably not do it. Does that mean I shouldn't be doing this now? I had everything planned for having the surgery now. I'm having a tough time accepting that I might not have the surgery. I'm so confused -- and a ilttle sad. I really wanted this to happen now.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

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