Hello. I wanted to put something clever in my subject line so you'd want to click the post and read it...

Anyway, my name is, perhaps not surprisingly, Jonathan. I'm scheduled to have lab band surgery at the Molding Clinic in TJ on January 11th. I just found this site, and due to some (albeit unsupported) statements against the Molding Clinic, I have to admit I'm having some concerns.

I had a frustrating experience with Humana. I knew I had an obesity exclusion (excluding weight loss surgery or any other treatment for obesity) and when I called Humana to ask them about it, I quoted the part of my coverage document that stated it. They told me there was still hope, that I needed to go through preauthorization and then let the appropriate division in Humana make the decision. After receiving the preauthorization request, I was told that they were going to deny me, because I had an exclusion in my policy. I told them that I *knew* I had an exclusion, and that I'd pointed it out before, and the person told me that the customer service representitives have to tell patients what I was told, because they're not "qualified" to interpret a coverage document... or something to that effect. If you're thinking what I've typed here makes no sense, then you're at the same place I am.

Anyway, my understanding is that I'll have no luck appealing the decision, since the policy clearly states that WLS is an exclusion, so I've decided to go the Mexico way.

A couple of years ago I lost 100 lbs, and swore to myself I'd *never* gain it back. I went from 316 to 215. I'm now at 330 lbs. I'm sure my story isn't unique in this group, so I'll stop it there, and ask a couple of questions.

1) Does anyone here have good or bad experiences with the Molding Clinic they'd like to share? I did a search, and didn't really find much, other than what I mentioned at the start of this post.

2) When I was going to have surgery in the US, I was told I had to be on a strict, low carb 2 week pre-op diet, designed to shrink the size of my liver. I've read here that some people have been on a 1 week liquid diet before surgery. I was told by Andres at the Molding Clinic that no pre-op diet was necessary. Any thoughts or comments on the pre-op diet thing?

I look forward to the fellowship and support I'm sure I'll both find and give in this forum in the years to come.

Jonathan

Clever indeed to capture our attention with a title like that one!

My insurance had an exclution also. I ended up using Dr. Spivac out of Houston and love that decision esp. after hearing all the night mare after care stories from the Mexico patients. I paid around 13,000 for the proceedure that covers 1 year after care also.

I was'nt instructed to go on any particual diet except dont eat after midnight the night before surgery. Then I joined this furum and seen all there restictions and was amazed at my docs POV on things. I appreciate his profesional capabilities it does surprise me how relaxed he is about things. But I have faith that he knows what he is doing. So far so good.