Veterans Administration and Lap Band Surgery?

Pete53 · August 27, 2006

Randi:

Thanks but according to my Doc Methodist in Dallas is certified and it is not on the list. I am not going to worry about it got to many other things.

I appreciate all the research that you do.

Randi · August 28, 2006

Randi:
Thanks but according to my Doc Methodist in Dallas is certified and it is not on the list. I am not going to worry about it got to many other things.

I appreciate all the research that you do.

That's probably quite true about Methodist being on the list. A few months ago, there were hardly any listed in Texas, but I noticed that this time there were quite a few more facilities that have since received the designation. BTW, I'm located in San Antonio and way before Medicare implemented their policy, the Methodist Hospital here had already received the designation.

The only people who absolutely have to be concerned about the designation currently are those who use Medicare. If the facility is not designated a Center of Excellence, then Medicare won't pay for the surgery or the fills. One LBTer shared her story with us . . . Medicare had paid for the band, but between the time of her band being implanted and her first fill the new rule was implemented and she was unable to get her fill. I think she worked something out with her surgeon to get a fill, but it was tough going there for a while. In San Antonio, fills run about $200, but based where this lady was located her fills/unfills cost $650. Yikes!

Pete53 · August 28, 2006

Randi:

Figures my Doc told me that it had to be Methodist and the Insurance is a Medicare HMO so I guess they have to play by Medicare rules.

He told me that Doctors a Tenet Hospital is close to certification. From info posted earlier in this thread you would think that Insurance would love Lap Band as VA says that it saves a lot of money.

Randi · August 29, 2006

Pete,

I would venture to guess that insurance companies look at the lapband from the standpoint of re-operation costs. After all, the band itself consists of three main components that can possibly break down -- band, tubing, and port -- not to mention all the other things that can go wrong -- can't be tolerated by the recipient, band erosion, slippage, stoma obstuction, etc.

However, even with all that could go wrong, I'll take my chances with the band over the gastric bypass any day. Did you know that some people who have had gastric bypass are now getting the lapband implanted because they have regained weight and stretched the pouch created from the bypass? Undoubtedly, the adjustability of the band is a very appealing feature.

It makes me wonder how many gastric bypass patients would have opted for the band if it was available at the time through their insurance companies?

Pete53 · August 29, 2006

Randi:

Not much surprises me any more. I have become a cynic in my old age. I find also that the research I am doing now is exciting and I think that when I get banded I will be better able to do my part.

Anyway my job is to make the appointments and get ready. I would like to drop to 190 but in all reality I would be a success if I got to 220. Which reminds me to ask. How do you select your goal?

Randi · August 29, 2006

Randi:
Not much surprises me any more. I have become a cynic in my old age. I find also that the research I am doing now is exciting and I think that when I get banded I will be better able to do my part.

Anyway my job is to make the appointments and get ready. I would like to drop to 190 but in all reality I would be a success if I got to 220. Which reminds me to ask. How do you select your goal?

Pete,

Your surgeon would be the first place to start on defining your initial goal, which I believe is usually to lose 50% of your excess weight. From there on, my guess is it's individual per person. Why don't you post a thread to ask the LBTers how they set their weight loss goals?