Ok so here goes,

I am 44 years old and I weigh 245. I have no insurance. I need weight loss surgery. I need help!

I am asking for advise from start to finish. I can get insurance but I need to know what type and how long I need to have the insurance before I can start the surgery program. I have not been to a Doctor in a couple years, but I have managed to lose some weight but of course put it back on. I realize that my only hope now is to have the surgery. Please give me any and all advise.

Thank you so much!

Vicki

Each insurance is different on the requirements. I have Blue Cross blue Shield (anthem) and they had me do 6 months of Dr. supervised visits for weight loss (I didn't lose a thing). I would just check out and ask specific questions when you are inquiring to various insurance groups to fax you their specific policies regarding lapband surgery and specifically ask how long you have to be insured before it will cover. You don't want to get into it and then have any surprises come up. Good luck with your journey!

Some insurance companies require proof of a history of obesity for x number of years. If you haven't been to a doctor in 2 years, that is something to be aware of. You don't say how tall you are, but the requirements are based on BMI, you can find a calculator online. Most insurance requirements are a BMI of 35-39 with 1 or 2 co-morbidities such as diabetes, high blood pressure, sleep apnea, etc. Or BMI 40 and over qualifies. Many companies require a 6 month medically supervised diet program.

You'll have to check for a pre-exisisting condition clause, see if you need to be covered for a certain amount of time before they will cover bariatric surgery. Be certain there is not an exclusion of it.

All the insurance companies are slightly different. These are generalizations. Most have their plan brochures online and a google search will bring you to them.

Good luck and best wishes! Welcome to LBT, keep asking questions!

Your profile doesn't say where you reside but I'd google bariatric surgery or click on surgeon in the tab bar at the top of this page. Most surgeons offer seminars on how the band works and what you will need to do. Also, they can give you information on support group meetings in your area that you can attend. Go to 2-3 seminars and sit in on several support groups before you decide.

If insurance becomes a problem, consider self-pay. It's usually in the neighborhood of $10K which seems like a lot but most people will drop $20K on a car without a thought. Wish I would have done this years ago with or without insurance.

Researching, identifying, and selecting an insurance carrier that covers WLS, will accept you as a subscriber at a premium you can afford to pay, and will eventually approve you for surgery sounds to me like an enormous task for an individual patient to undertake. Doing all that could add years to your journey. I suggest that instead, you research bariatric surgery clinics in your area, attend an educational seminar, and hook up with a clinic's insurance coordinator to get suggestions for how to deal with the insurance issue.

If you eventually decide to self-pay as 2muchfun suggested, I wouldn't recommend the band. Don't get me wrong, I love my band, but the band requires a LOT more aftercare than the other procedures because it usually doesn't work without fills, and those fills (and unfills) can get to be expensive both in terms of cash and in terms of your time and energy. You'd also need to consider the possible expense of revisional or corrective surgery if something went wrong. For example, my port flipped over so I needed surgery to reposition it. My insurance company was billed a total of $34,628.70 for the repair surgery, and paid the providers a total of $4850.11. I don't know about you, but I don't usually have an extra $5000 stuffed under my mattress!

Jean

i didnt have insurance either so i was looking around for a while and was even considering going to mexico for a long time. my mom had some patients that went there and had great experiences its 5000 there. i ended up finding a dr in my state that did it for 8000. his name is dr morris washington hes on this website under the surgeons tab. i just went on the lapband website and called all the drs within a 2 state radius. since U.S. drs have to compete with prices out of the country some of them are willing to work with u. i am getting lasik on friday and i got a deal cuz i called them back afrter my eval and told them that i found a clinic in canada that did the same kind of ilasik for cheaper and they gave me a deal. well i dont know if this even really helped but good luck on your jouney!!!! its super awesome being banded. i just got banded thursday and i feel pretty good considering i have a plastic ring strangling my stomach..... im still pretty swollen and i lost 20 lbs since i started my pre surgery cleanse which wasnt hard at all.