Here We Go

[GREATFUL 24]

I just love this place. It is great just to read and soak up all of the experiences that everyone has been through. It also helps me to know what I am experiencing is just part of the process. I made up my mind that the Lap Band was for me. I got a copy of my insurance Benefit Pland and looked to see if Bariatic Surgery was covered. It said it was with this additional wording "In determining if there is coverage for these operations, specific medical necessity criteria may need to be met". That should of been my first clue that I was going to have problems. I called them and asked them what these requirements were. They told me to be covered I need to have a BMI of 40 or greater. I do, so feeling all good about that. I would need to use a surgen in my network. I found one, now feeling real good. Be insured by them for 2 years, I have been. Thinking this is going to be a breeze. Go to the seminar, give my insurance info to the surgens office to pre cert me. SUPRISE SUPRISE SUPRISE.... they tell her that I have to have a letter from PCP, 1-3 years of medical history and TSH clearance (if anyone can tell me what that is I would love to know). Getting all of this done is no biggie. It is just that they tell you one thing and it turns out to be totally something diffrent. OH WELL..... I am at least on my way. Made my appointment with PCP on next Tues, have my appointment for Psychological Eval. next thurs. So next week will be very busy. Reading this site has helped me not to go crazy. Thanks Guys!!

[juliegeraci 7]

Laura, hang in there. I originally was rejected due to my surgeon being out of network. I finally got approved about 8 weeks later.