Im new here and I love reading everyone's experiences. I always thought that bariactic surgery was just the easy way out until a friend got the fobi pouch. It's been quite a journey for her and has made me look at weight loss surgery in a completely different light. I am very interested in getting the lap band, but I don't think my doctor wants me to get it and I need her recommendation.. Right?! If anyone can help with their experiences that would be great. I'm 30 and about 260... My BMI is EXTREMILY high so there is no question that I do qualify for this surgery.

Well not really what insurance do you have? My ins requires that you have a BMI of 40 or higher or a BMI of 35 with two comorbids and I have to use an in network doctor!!

I have Kaiser Permanente. I checked my policy and it said that it doesn't cover it. Do I just go to my doctor and say I want this done?

*does! Not doesn't! Lol

I have a PPO so I didn't need my PCP I made my appointment with the Surgeon and got all the info I needed and started my journey. Good luck with your everything!

*with your journey* oops

Thanks Lolita! sorry for the ignorance lol but what's a PCP?

Primary care physician

Primary care doctor and you must live on Cali right? I believe your ins is state ins correct? So I do believe you would need a referral from you pcp! I would start there and good luck

Umm I don't think I have state insurance. I have it through the company I work for.

Umm I don't think I have state insurance. I have Kaiser through the company I work for.. And yes, in Cali. What kind of insurance do you have Teresa?

I went to a seminar and a surgent gave me paperwork for my pcp to fillout every month with diet/weigh in. after six months it gets put in insurance.

I actually have a male doctor and did not feel comfcrtable talking to him about it so I went to my OBGYN doctor and asked her for the referal. She gave it to me and BCBS excepted it. Maybe you could try that.

I actually work for an insurance company that's partnered (sort of) with Kaiser - We have reciprocal benefits in each other's areas. Anyways, you would need a referral from a primary care physician, and they would refer you to an in-network doctor. I'm sort of new in the process (though I have had my psych eval, ekg, bloodwork, etc, I just need a surgery date), and my PCP first referred me to the surgeon, and then I went from there.

My insurance requirements that I am falling under at the time is a BMI over 35 and a comorbidity - I'm currently at 36, and have sleep apnea, so I'm pushing it... but the surgeon is gung ho about it, and my insurance seems to be supporting it so far...

I have united health care! I work in an ER in Phoenix and I know when we have patients that have Kaiser we have to get Auth! And I only meant state because I think I don't know for sure but isn't kaiser only in Cali? If your insurance covers it you probably only need to get a referral!

There are Kaisers in Oregon, DC, Cali, Georgia, and one other place that's eluding me... and they all offer the reciprocal benefits under a "visiting member" status, which is for 90 days, after that the insured either has to switch to the local insurance or they have to return to their home plan. Auth is definitely required for the surgical procedure, but if you've got a PPO you can usually self-refer for the consultation, they just need to submit for an auth prior to surgery. HMOs will definitely require a referral for the initial consultation, and then a referral for the surgery.

I should probably add a disclaimer that I only know benefits for the company I work with and it's an absolute necessity for someone to check their plan before proceeding! Knowing your benefits can be a powerful thing if you know how to weld them properly!