I just got off the phone with Dr. Storeys office (Houston) and they told me that after 6 months with them and being monitored by a dietician and exercise they will submit it to the insurance company. I am not willing to wait 6 more months. I told the girl I would be dead by then.

Did anyone have to wait like that? Is that the norm?

How absurd for them to even say that! If people could get the weight off by just watching what they eat then they could just waive their magic wand and it would be done now wouldn't it!!??!!

It's not like getting fat has happened to me overnight, I have been battling weight all my life and with hypothyroidism thrown in there to mix it all up.

Its not like lap band surgery is a quick fix for goodness sake its still major surgery and I don't think anyone out there thinks its an easy solution. But how freaking fat do you have to get before enough is enough?

Sorry to rant an rave but this is frustrating!

I agree, a 6 month wait for a lifetime change isn't very long....although it feels like forever! It will be worth the wait, no doubt.

I started my process in June 2005. After being watched by a dietician & after all the tests, x-rays, other doctor appointments (psychologist, anasthesiologist, etc) I finally got an appointment to be banded in December 2006. I didn't think it would EVER happen! But I kept doing everything they wanted me to do. Jump through all their hoops & be patient. It will happen at exactly the precise moment you & your doctors are perfectly ready.

It is a long process for most of us, but I hope it doesn't discourage you! Keep your chin up, it will happen!

I also had to wait and thought the same as you...But it all worked out for the best. Take the time to read more about the band your getting in the next 6 months and how to make it work for the rest of your life...best of luck to you! It will be here in no time -trust me!

I went to a seminar Sept 29, my doctors filed my insurance (after I supplied them with my medical history, psych eval, and dr referral) I was approved November26th and had my surgery Dec 13. So six months? I would scout out a different dr. If you are close to Texarkana use Heiker and Keilin. If your in Dallas I can find out who did my aunts. To me six months is rediculous, unless there are other factors in the equation. Good Luck!!!

Margo,

I am assuming your doctor's office is experienced in Lap Band surgery, so most likely it is generally dependent on your insurance policy requirements.

We have been doing this for several years and have done hundreds of patients and we still have some that require 6 months of 'paperwork' or even more!

More and more insurance companies want what we call 'a 6 month multi'

That means you need documentation of a multidisciplinary approach to weight loss in including diet, exercise, nutrition, etc. Then factor in some of the games insurance companies play (oh, we never got the paperwork, send it again... etc)

If you don't have any documentation to support a 6month multi before you see your surgeon you would have to start a program afterwards.

By the way, it works on both ends. I just got reimbursed on a Lap Band we did on August. The insurnace pre-approved and pre-authorized the procedure, yet it took about 5 months for them to pay for the procedure and this only after countless phone calls. :girl_hug: So if it can take five months for the insurance company to pay for a surgery they have pre-authorized and pre-approved, it can certainly take that long for them to approve it in the first place.

I am sorta in the same boat as you. My primary doc refered me to a nutritionist and told me I will have to be on a diet program for 6 months first. He also said I have to go to a physical therapist for a workout program. This is lame because I teach excerise classes and was a personal trainer for 10 years ( yes I am 5'2 @C 220 and still teach fitness, brave yet still fighting a huge weight problem). He then said I have to get a psyc eval. I am figuring to get all this done will take a long time, maybe a year.

If I even get approved, who knows.

Kitty (Healthnet HMO)

I just got off the phone with Dr. Storeys office (Houston) and they told me that after 6 months with them and being monitored by a dietician and exercise they will submit it to the insurance company. I am not willing to wait 6 more months. I told the girl I would be dead by then.

Did anyone have to wait like that? Is that the norm?

How absurd for them to even say that! If people could get the weight off by just watching what they eat then they could just waive their magic wand and it would be done now wouldn't it!!??!!

It's not like getting fat has happened to me overnight, I have been battling weight all my life and with hypothyroidism thrown in there to mix it all up.

Its not like lap band surgery is a quick fix for goodness sake its still major surgery and I don't think anyone out there thinks its an easy solution. But how freaking fat do you have to get before enough is enough?

Sorry to rant an rave but this is frustrating!

I'm with you margo....... all the way!

I waited a year and a half for a new insurance that would cover it... until October 2005. Then I thought I'd be 'under the knife' within 2-3 months, but it took 10 months!! :omg: It wasn't an insurance hold up at that point.... from my point of view it was the doctors covering EVERY base health-wise. But if I was perfectly healthy, why would I be going through all this? And like you, if I was able to diet and exercise successfully, I wouldn't have gotten to this weight in the first place! But basically they seemed to be in no hurry, as my weight crushed my knees day-by-day. I was as frustrated as you seem to be...... I wish I had the answer for you. I kept pressing but in the end I was at their mercy: to find someone else would not be so easy; and starting over (from the BEGINNING!) with new doctors didn't seem likely to speed things up.

So I can't tell you the time will fly by..... mine didn't!! I was suffering and desperate and I had to keep pushing. If you can change surgeons, do it now... don't wait. Otherwise just bug the h:mad:ll out of them!!

As you said, the band is not the whole answer... you WILL have to eat better and work a bit. On the bright side, waiting and waiting... getting frustrated with the whole system, made me determined to use the diet and exercise to get the weight off so that I wouldn't have to go through all that again! I never thought I would be able to do that!

Sorry to burst the 'happy talk' bubble...... but I never want to deal with this kinda stuff again. I'll get my health back in any way I can!! This journey has been too arduous to ever consider repeating!!!:angry

Good luck margo...... get it done any way you can!

Having an insurance company that wants to pay is worth the hurdles you have to jump through.

Mine said, "NO", no questions asked. No matter what.

I have been thinking about this for nearly a year now, and I started the ball rolling in August. My surgery date is January 29th, so that's a total of 5 months, and that is for self pay! In the beginning, I thought 5 months was too long to wait, but now my date is near and I can look back and say it went quicker than I expected.

It does fly by fast.....

Margo,

I completely understand your frustration, I too found out I needed the six month diet and that was after the insurance company took 2 months to reply to the perdetermination letter. I just had my third doctor's appointment which by the way because of my plan, I pay for and as everyone else has said, it does seem to go fast. Regarding the stall tactic, I just want to say that I think there is very little evidence (that I know of) that shows delaying weightloss is beneficial so all I can think is that it is designed to make you give up, go away, die, or change insurance companies:confused: . I suggest you confirm who is imposing the reqirement, insurance company or doctor. In the meantime make those appointments and keep them as I understand if they are not in succession you will have to start over. Fight it if you can, otherwise summon the patience to wait it out. Good luck

Good journey,

Terri

It took me over three years to get the surgery approved with my insurance company, even though several of my doctors submitted "statements of necessity". I was FINALLY approved recently, but not until multiple appeals were denied, gained 30 more pounds, was diagnosed with sleep apnea, diabetes, and severe back problems. I think the insurance company finally realized I wasn't going to give up...

My surgery is in two weeks - I pray that it is all worth it!

Hang in there! Believe me when I tell you, I said the same thing... Six months is a long time, but just think about how much weight you will be able to lose in the six months after surgery!

Regence Blueshield just added LapBand to their list of coverages, but they require an entire 12 months of supervised weight loss. Geez. Too long for me. I had 10 months with LA Weight Loss, let's see what they do with that? :heh:

Margo,

I have Tufts HMO and I just made it under the wire (hopefully). As of March 6th they are requiring GET THIS 1 FULL YEAR of a supervised monitored weight loss center, Online Weight Watchers would quality. That is nuts! I've only had my first consult this Thurs. and a couple of group meetings, now they are rushing everything to get me approved under the wire! They just found out about this last week. If I can't make the deadline I am going to be soooo disappointed as I have been researching this for months and months.

I'm 52 years old..I would have lost it by now if I could!!

Same thing is happening with me. I started my journey in May 06.

Once I got all of my tests in, they called me within a couple of days

with a surgery date of 2-12-07. Then called a few days later to let

me know the Insurance wants the 6 months supervised diet. They

should have told me awhile back, so that I could have been done.

Oh well, i'm over it. Went to the Doc today to start the diet. they

will start it with my last visit at the beginning of Jan. I usually see

a nurse practioner, I hope the insurance has no problem with that. :phanvan

Patti

I would not have wanted to wait 6 months. I will have most of my weight off in that length of time. I am not patient. I want it off and this band is going to help me do just that. And keep it off.

I wish you the best, Margo.

As I have said, I started this whole procedure in April 06 and finally have my date, Feb. 12. I have BCBS. This has taken along time, friends and family were asking do you have a date yet? When I started they said about 16 weeks. Some where along the way the time must have been changed, but nobody told me. But it is here now, so hopefully they don't cancel or postpone this.

Same thing is happening with me. I started my journey in May 06.

Once I got all of my tests in, they called me within a couple of days

with a surgery date of 2-12-07. Then called a few days later to let

me know the Insurance wants the 6 months supervised diet. They

should have told me awhile back, so that I could have been done.

Oh well, i'm over it. Went to the Doc today to start the diet. they

will start it with my last visit at the beginning of Jan. I usually see

a nurse practioner, I hope the insurance has no problem with that. :phanvan

Patti

Good Gracious!!!!!!!!!!What a let down. To think you were going in for surgery on Feb 12 and then told you have to do the six months diet.

At least they are letting you start from the beginning of Jan. This is my worst fear, that after the 6 months, they will either say no, or make me go through other things that will take more time.