Hello! I just joined. I live in ND and am looking forward to having the lapband surgery sometime mid to end of April. Hopefully my insurance cooperates and it goes that fast. I am very, very excited with my decision and looking forward to a new life of better health.

I have BCBSIL if anyone has experience with them let me know.

Thanks a bunch!

Tarra

Hi Tarra:

I am from SD so welcome neighbor!! Where are you planning to have yours done? I am going to Fargo on Monday for the seminar at Merit Care and plan to have Dr. Monson. As far as I can tell with my insurance, they will cover it (I have BCBS-MN). Hope things work out for you!!

Robin

Hi guys!! North Dakotan here! I can't help you with insurance experience because when I had mine done, BCBS didn't cover the procedure so I went to Mexico. Also when I had mine done, Merit Care wasn't even doing the procedure. I have gone to Bismarck for aftercare, they are super nice there. Do you live closer to Fargo or Bismarck? I ask because I would definately recommend Dr. Schmit if you live closer to Bismarck.

Well, good luck in your new adventure in Banding!!! If you have any questions, please ask!!

Hi!! So exciting to meet neighbors!!

I am going to Dr. Schmit in Bismarck. I live here in Bismarck and I have had him before. He did a biopsy on my breast in November. He was so kind. My sister had passed away a week prior (cancer) and I was really sad. His bedside manner just touched my heart. So... I am sticking with him. The coordinator for bariatric surgeries there is really great too.

Mexico huh? How much less did it cost there?

Best Wishes,

Tarra

Hello

I am from Mass.And have bcbs they are covering me as long as it is medically necessary and it is for me thye will pay.Sorry about your sister

Thank you Mary1094. I miss her. But losing her has been a real motivation for me to start LIVING, and get healthy. She is my guardian angel now. :think

Hi!! So exciting to meet neighbors!!

I am going to Dr. Schmit in Bismarck. I live here in Bismarck and I have had him before. He did a biopsy on my breast in November. He was so kind. My sister had passed away a week prior (cancer) and I was really sad. His bedside manner just touched my heart. So... I am sticking with him. The coordinator for bariatric surgeries there is really great too.

Mexico huh? How much less did it cost there?

Best Wishes,

Tarra

Hi Tarra,

In Mexico I paid around $8000.00, where Bismarck was, at the time anyway, $12,000.00. Plus, I kind of got a little mini-vacation, I had never been to San Diego before so that was cool.

nice to see this thread!

I am on my last resort to getting my insurance to cover surgery. They denied, then denied my appeal, but lots has happened in the past few months...they MAY reconsider.

Either way, I am having surgery - not scheduled yet. If my last resort with insurance doesn't work, I will either go to Bismarck to Dr. Schmitt or to Colorado to Dr. Schmitt, maybe Mexico, but a little unsure of that yet.

I live in Fargo and have seen Dr. Monson. I did just find out today that Meritcare will now do fills for patients that had surgery outside of Meritcare - that was not the case last Fall.

I too want my health back. I have tried and tried to lose weight, but it just doesn't work. I hope the band will be the tool I need.

Hello Disney! So happy to meet another person from the great north tundra who is going through this. Definitely keep us posted on how you're doing and what happens. I am so excited.... I pray I am not denied. What kind of Ins do you have?

Tarra, good luck with your surgery. You will love being banded.

I live in Fargo and have seen Dr. Monson. I did just find out today that Meritcare will now do fills for patients that had surgery outside of Meritcare - that was not the case last Fall.

HOLD THE PHONE!!! Are you serious? They will do fills for other patients now? THAT IS AWESOME, I live soooo much closer to Fargo than Bismarck, I am calling them right away! Thank you so much for posting that information, you are a life saver!!!!!

:clap2: :clap2:

My insurance is BCBS of ND AND I have two policies with coverage. I was turned down because my BMI was not 40. It is 39.....but, I was diagnosed with sleep apnea 2 weeks before the request was submitted. At the time, the CPAP worked OK, because I was sleeping so horrribly.

They denied because they said I did not have a co-morbid condition and the surgery was not medically necessary. They didn't count the Sleep Apnea because it was controlled by CPAP (for 2 weeks). They appealed, and still denied. The second denial happened in August.

After that I was defeated. Shortly thereafter (September), I had some medical problems and had to have a surgery that made me put this on the back burner. I have since recovered and am more determined than ever.

However, between August and now, the CPAP is not doing the job anymore....it only lasted a few weeks, and I am not tolerating it well at all. I remove the mask during my sleep and wake up several times. When I spoke to my insurance, they told me to resubmit....so we will see.

I am determined one way or another to do this. I am a tad nervous about going to Mexico, though I like their price. Bismarck is $13,000, Fargo is $17,000, and the Dr. in Colorado is just under $10,000.

Lots of information, but I am very happy to find some locals on here, and now you understand why I was not approved. If my BMI had been 40, it wouldn't have mattered if I had co-morbidities, insurance would have covered. However, the BMI had to be that for 3 years.

Thanks

Yeah, it really pays to have insurance doesn't it. Men can get Viagra no problem.....

I also have BCBS of ND, when I got my surgery they didn't cover anything except Bypass, so when I heard they started covering I called to see if my fills could be covered, yeah right...I got a BIG FAT NO!

I really hope that it works out for you this time around.

Welcome to LBT tara

Best wishes on getting your surgery date...hopefully sooner rather than later. keep us posted...

becky

Just reading and I also have BCBSND...I went to the informational meeting at MeritCare on 1/22/07. I then took the physc test on 2/16/07. Then on 3/30/07 went back to Fargo, ND to go over my physc test. Now I am waiting for MeritCare to call me to schedule a consultation appt. with Dr. Monson. I assumed that since the coordinator for MeritCare/Dr. Monson has all my past medical records that they should have an idea if I would be accepted or denied by my ins. Maybe I am wrong to assume this. Maybe a lot depends on which plan a person has through BCBSND..I don't know. I am also wondering if there is something that I should be doing in the meantime while I am waiting to even meet with the dr.?

If your BMI is 40 or above, they typically approve quickly without comorbidities. My problem is that my BMI was 38. If your BMI is 35-40 and you have a life threatening comorbidity (diabetes, high blood pressure, high cholesterol, sleep apnea, etc) and the comorbidity is not being successfully treated, it should get approved.

I am trying again, as some things have changed, and some of my issues are not controlled anymore. They (Meritcare) usually have a pretty good idea of who will get approved. I did all the requirements before I saw Dr. Monson, but for whatever reason, insurance didn't approve.

Good luck to you.