It is 99.9% sure that I will be denied having my insurance cover the surgery.

I spoke with two people in our Health Plans office and two reviewers from my insurance company and it does not look good at all.

I have 3 dietician appointments yet and unless the surgeon becomes a pulitzer prize winning dx writer, I am sunk.

I always knew there was a possibility that this would happen. I have a BMI of 37 and my co-morbidities are "soft". I didn't expect to be this let down. I have been dreaming of buying things off sale racks and having more energy and being skinnier and healthier. I still want to get there, but GOD THIS SUCKS!

Escpically after the RN was telling me all these great results of patients they have. AND she told us of a lady who had the surgery last Oct and has lost one pound. Someone like that can get coverage and then, what I think, waste 20,000 bucks and not do the right thing and here I am DESPERATE. This is so sad, I can't even talk about it anymore.

There is always the option of taking a Healthcare Card. It's like a credit card, I think Capital One is the most used, and you just finance it and then pay it off......If you are totally serious about having the surgery, this might be something worth checking into.

I know, I have heard of that option. I can't put my family financially in that spot right now.

MMS -- I am so sorry. Look at all the posts regarding insurance... because I know I've read more than a few times where people were approved after first being denied. File and appeal. I'm sure your doctor is well versed in writing these letters, so don't lose hope yet!!

Have you considered have surgery in Mexico? I was too denied by my insurance company due to low BMI. I did lots of research and found a great Dr. that has been doing it for 12 years and have trained many of the US doctors. I wonly paid $7900 which incuded everything except airfair. I highly recommend my doctor. Let me know if you would like more info. No...I am not a patient coordinator recruiting new patients.....just happy to send along my experience. Good Luck!

I have read a number of things about Mexico. It crossed my mind more than once. You can't help looking into it - it's everywhere you do reasearch on the band!

Even that amount would be a strectch for us right now. I am willing what I need to do to get healthier, but I won't do it at the expense of not paying necessary bills or feeding my kids. I just don't see getting that amount together anytime soon. We don't have a ton of expedible income right now and I can't justify sugery for what we do have.

I appreciate all the good ideas though. I did make the appointment with the surgeon and I will see what he has to say.

I think I may need an even LONGER psych eval. I can't believe how sh___y I feel!

I keep telling myself that I am healthy in every other way and that's a good thing and that I need to suck it up. There are thousands of people without health coverage and that have to walk themselves or seriously ill children to Doc's and I have no reason to complain about this little glitch.

The worst thing is. A friend of mine had her's done today. The day I find out mine is all falling apart. Ahhh irony, gotta love it. I didn't know she was getting it done til like a week ago. I was and am SUPER excited for her, she needs it way worse then me, but now I am jealous! I hate that. So not me and that's the part I hate the most! :rolleyes

I really feel for you! It is hard to come up with that kind of money, but there are ways, such as an extra job or talking to family for help. The other option, although I tried and failed many times, is to talk long walks (totally free) and cut down on calories. I wish you the best of luck and know you will find the answer one day.

MMS, I'm sorry this has you so down. But fight it down to the last appeal. That's what we did. We were told "No!" FOUR times. We were on our last appeal and the lady at my surgeon's office requested that the insurance company have someone who specializes in bariatric surgery look at my file.

The answer came back in 7 days "APPROVED!"

I'd all but given up, convinced it would be another NO and we'd have to find an alternative way to do it.

hi there,

this is what iam afraid of too. i am putting a call in tomorrow to see if my ins covers it but judging by their website, it is excluded. iam so afraid to take on the debt myself but i am really leaning toward being banded. i will cross my fingers for you , i hope they reconsider and cover you. good luck to you

I agree with NanaRenan, appeal til the very end! Don't give up. If it does end up with a final denial just consider that most of us have no trouble getting a loan for a car, home, boat, camper, etc... all of these are "things"...you are worth a loan if it will improve your health and you are indeed ready for this change!

It's a BIG blow, being denied by insurance. Here you are, working hard, doing everything required of you by the surgeon and insurance, and low and behold, a BMI under 40 or over 50 gets that automatic "no". Rediculous. Fight, Fight, Fight! If you really believe that you NEED this surgery, don't let the insurance company dismiss you without a fight.

There's A LOT of info on this site that can help you fight denials and tricks of the insurance trade. Do some searches, do your homework and when your time comes, you'll be so proud of yourself for conquering the obstacles! The weight loss will be that much sweeter for you

Best wishes and keep us posted.

Don't give up. I was denied and then approved 2 weeks later. My insurance requirements are:

- BMI of at least 40 for the past 5 years

or

- BMI of 30 and being treated for at least 2 of the following:

Heart Disease

Diabetes

High Blood Pressure

sleep Apnea

Well I was denied because 5 years ago my BMI went down to 39 on one of my visits to the doctors office. The insurance refused to budge an inch on this.

I don't have any health issues and I was freaking out. The only thing I do have is border line high blood pressure but only when I go to the doctor (white coat syndrome). The nurse at my lap band doctors office told me to go ahead and have the sleep apnea test done and also see if my family doctor would treat me for hypertension (high blood pressure).

I went and had the sleep study done and I ate the biggest hamburger, fries, coke, and McDonalds cinnamon roll in the parking lot of the place so that when I went in I was so full I was miserable.

I usually sleep on my stomach but I told them I sleep on my back. I heard that you snore more on your back. Guess what......it worked, I tossed and turned all night. The next morning they told me that I had a ruff night. Yeah I felt horrible alright and I had indigestion, but I now have sleep apnea.

I went to my family doctor and told him what I was doing and could he give me something for high blood pressure. He gave me Water pills for it.

I immediately sent the info in to my insurance and they approved me. I was denied 4 weeks ago and approved 3 weeks ago I had my surgery last Monday (1 week ago today).

Hope this gives you Hope.