Hi ya' all who read this thread.

I just want to be heard and find a connection with people who have a similar story.

Here it goes...

I have been overweight all my life. I can only remember a few times when I wasn't. I grew up with two brothers who ate what they wanted and were at normal weight. My mother would go out of her way so I would diet. I have been on every diet imaginable from SlimFast, to diet pills from GNC, joined gyms, Doctor paid for medically diets and exercised programs, Soup diet, cabbage diet, south beach, WW,.....on and on.... Some worked others were a joke..... But needless to say gained it all back. I am right now the biggest I have been in my life. I am so unhappy with my weight. I feel as thought a different person in my is trying to get out but none of what I do helps for the longterm.

I am tired of feeling the shame, of looking in a room to see if I am the biggest person or not.

but mostly I am tired of the loose, gain...loose gain...gain twice as much as I lost...etc...

I researched last weekend gastric bypass as it has been something on my mind for years now..but couldn't help feel guilty or like a failure for turning to what some people refer to as the "EASY" way. I know I need a medical intervention to win this battle and be at a lifetime healthy weight. So I got over it and researched this past Weekend and came across this lap-band. I love it...I have decided this is what I need.

I scheduled to what I thought was the informational seminar yesterday. It was an info seminar alright, but for Opti-Fast...what the crap...insurance does not pay, can only be cash or financed with the lender of the choice and cost $5,000. yeah right...walked right out... waisted 4 hours of my day in traffic, and away from family for that!

So I called the number I called initially and was finally scheduled for the correct seminar but i have to wait until 12/5/07.

My only concerns now are this.

I am 5'2" and W 233lbs home scale.

No comorbidities.... have documented doctor program from beg of this year in January until July 2007. Prior to that back in 2005 was the last doctor monitored program I did. I can probably get weight info from my gynecologist when my daughter was born back in 2002 of my weight prior and after pregnancy as I believe was a bmi slightly under insurance guidelines. I will have AETNA HMO effective 01/1/2008. I am snoring at night and began having asthma which I believe is weight related as well.

My questions are as follow:

Does anyone have any advise of how my case looks?

Do I stand a chance at getting approval without a long battle?

What is the process after attending the informational seminar all the way to the doctor's submittal to the insurance?

HELP desperate to know!!:help::confused::confused:

I am so glad for you. Now the waiting begins:eek:. Hang in there it will all fall into place before you know it. Start trying different protein shakes to find out which ones you like. I like the berry prodi drinks and Chocolate Unjury. There are many kinds, just ask around. Start walking if you can, and stop drink soda. Let us know what happens.

JP

WoooHooo!!! You did it! You got the ball rolling, now you just got to chase it down!!

You know what you need, and have a list to begin checking things off against.

Be as thorough as you can, and remember whatever you obtain---keep a copy for yourself!!! Packets going to insurance have been lost before, and while the Dr.s office should make all copies to send, it would be comforting to know you still have all items yourself as well!

I am so happy for you! Let us know if we can be of any help!

Kat

Thanks guys.....I started tonight gathering and searching online all the doctors names, address and tel#'s that I have seen the past 5 years so I can contact all the offices and request all medical records from each one. I hope I can gather enought to show routine checks were my weight will reflect I have been at a bmi of 35 or more for all these years.

Can't hurt to have too much can it?

That was great new 4Jin. Anything you can find will make it easier to get approval/

My doctor used the form at Surgical Weight Management - Bariatric Weight Loss Surgeons in Atlanta, Georgia performing Lap-Band and Gastric Bypass Surgeries for gathering information for submission to the insurance company. Check it out to get some ideas as to what info they want. Click on blue packet.

If you have ever taken medication for anything that can be connected to your weight....high blood pressure meds, diet pills, arthritis meds....anything, you can also get a print out from your pharmacy detailing that---my packet did not ask for it (also a BCBS but of TX),but we included it. If you have receipts from attending Weight Watchers, or receipts from food programs like Jenny Craig---you can include them. Also gym memberships.....anything you did to try to lose the weight in the past, can be included. They will even include a letter from you, detailing why you want this surgery. I have never heard from an actual insurer whether it helps or not, but I cannot see it hurting.

Sounds like you are getting it together!!

Yea!

Kat

hi! i am so glad you are so optimistic about the process. i feel the same way. i have 2 months left of my 6 month mwl program and i should be set. im on the hunt right now for my sleep study report from a few years ago, but then thats it. good luck....i know it will be worth it for us!

$j, Good job. It looks like you are really into this. I hope I have as much luck when I start the process. I am changing carriers at the first of the year. I know the new one covers, not sure about the existing. I am new to the boards, looking for friends who have gone through or are going through this. We can learn so much from each other.

I haven't been able to post. Very busy...but I guess it helped get me distracted and worry free for a couple of days. I am a worry freak and will be until I am approved. then I will find something else to worry about i'm sure.

I went thru my mail and it looks like yesterday I received my informational package and confirmation of seminar for Nov 15. Now I am more excited than I was previously....jeezz..

can't get over myself.

Also I will be checking out body bugg.....looks like i'll be buying that soon as well.

thanks for all your advice ,....that is great...no one better to tell my story than myself to the insurance company....

I guess it should not hurt....

You really need to call your insurance company instead of trying to find out what we think - they have the answers for you. I called mine right away and they were very nice and explained everything to me and all the requirements. BC is a great one. I have BC MA and they are paying 100%.

You do stand a chance at having the lap band weight loss surgery. For starters your bmi is probably over 40 and with your health problems that will help you get approved. I had alot of health problems along with being overweight,I wasn't 100lbs overweight but i had enough health problems to get approved. I am 5'2 also and i weighed 216 at the most when i started on my journey to having the surgery. Most insurances require a six month study with your Dr and a weight loss program before they will approve the surgery. I wish you the best of luck on your journey.

On January 2007 I placed my own self on a medically supervised WLS program.

Before I decided to go such a route as to having anything placed, replaced, removed..added...whatever you may call it.....or anything dealing with a hospital or anesthesia or pain I tried it.

I have put more effort in my life loosing weight and trying to keep it off in a month than most naturally "skinny" will ever try in their life.

I was on the medically super expensive medically supervised plan for over 6 months the weight came off but very slow. It was working don't get me wrong, I even recruited a buddy to the program. I motivated co-workers and we even signed up as a team for a marathon-walk. Which by the way we accomplished.

But I became fustrated....even the Doctor was fustrated...he recommended me as an excellent candidate for surgery.

He advised me to research it. I left it alone for a couple of months.

I was exercising more and am trying harder than anyone else that ended up going to the Doctor because of me and signing up for the medically supervised plan...yes it is fustrating when people that started after I did lost more than I did. There is even a wonderful story about one that has lost almost 65 lbs.

Yes the doctor admitted for all the efforts I was putting in my loss should have been greater. But ofcourse blame it on anything but an attempt to find out exactly what it is...he said sometimes genetics are what they are and only true long time maintenance that is offered is surgery for a healthy life. Not this constant rollercoaster my weight has always been.

is it fair...of course not...but I am aware life is not fair.

Did I stick to it ..yes I did...heck yes.. Is it plainfully hurting to hear the own doctor I am paying big bucks to say...well you have been carrying that weight around for such a long time your body will resist.

The angry part is I was flippin' paying for the whole plan. As a matter of fact I have two medical insurers one from my employer and my husbands employer plan as secondary...but guess what... The program is not covered.....who paid for it....I DID!!

I paid for it all. The consults, the pills, the shots, the lab work. You name if...he blinked....I blinked...I wrote checks....

I was going to the gym either at work or private....I walked with my buddies on breaks & during lunch..... Committment...you name it I have had it....then why does this not work?

Exactly what the doctor said....other options exists for people in your situation....thank goodness...however so I don't have to continue closing my eyes and writing checks....those two cards that have been collecting dust in my wallet will be put to use..... I called both insurers and they both cover obesity surgeries. I received a copy of the general requirements....And I do meet all of them...Now the process just begins...

I hope my fustrations don't offend anyone....

But I do wish that my fustrations and experiences do help someone who has started this process and is in the same boat ride as I am.

<p><p>Ok....taking all advice I have received...I wrote down all the medically supervised plans, all the non-medical plans, all the pills, diets...gyms...methods...I have done over the past 7 years....Wow there is a lot of them. No wonder my husband would give me that here we go again look everytime I mentioned something about loosing weight...</p> <p>I gathered all that info...and found address and tel#'s for all doctors as well that have medical info or where I have gone for other things but have my weight and vitals documented. </p> <p> Most I have to wait for a call back...One of them was successful at the first try and I paid the fee over the phone and will be receiving my records, another I faxed the authorization form and should be in the mail to my PCP by the end of the month. It went better than I expected. </p> <p> I even found my gym membership contract. </p> <p>What I found interesting was why most even ask why am I requesting MY records...hello...last I checked they are MY health info. Don't I have a right to see it if I want without having to tell you what it is for....but as a true professional, friendly person...I gave the politically correct answers....darn it!!!</p></p>

Just stopping by to say...hi