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How long & what to expect...

My doctor recommended Lap-band for me a couple of months ago. I have a BMI >40, high blood pressure, high chol, edge of Type 2 diabetes... To boot - I have lost & gained probably 500 lbs in 10 years. Whew.

My questions... Once I go to a Lap-band doctor in January, what can I expect? Will insurance cover it with my scenario? From my first appointment, how long will it take to have the surgery? For the first steps of the process, what am I looking at?

BTW - This forum has been god sent. Thanks!:help:

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i dont see why it shouldnt depends on your insurance company. What i did is i called the insurance before i went to the doctor to see if they cover it if it was medically necessary cause i felt why go through all that work if they are just gonna deny it. but remember make sure all paperwork necessary is sent in to get your approval even if you think they probably wont need it send it anyway.youll make it and youll love it gl in your journey of becoming a bandster!

Hi CharleyBoy. My surgery took about 6 weeks after my initial consult. I had to the the psych eval, the nutrionist and lab work. They originally denied me because he was out of network. Dealing with them covering me in network was probably a 2-3 week delay. So if you get covered fast you may have surgery fairly quickly.

Hi, I went to my first consult in late Aug., had my pysch. eval. & nutrition eval. in Sept., met with the surgeon in Nov. and my surgery is scheduled the day after tomorrow. My insurance took about 3 weeks for approval. My advice to you is to first call your insurance co. or read the manual (if you have one) to see what the requirements are. From reading other people's experiences here it varies from one insurance co. to another. I have a BMI of 43 but no co-morbities and was approved the first time. Good luck with your journey!

Jenn

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Sounds good... My General Practioner is recommending the procedure. Does this speed up the process with the insurance company?

I appreciate the support... This is a profound decision.

Hi Charley-

My insurance would not cover mine, so I am going with cash. My company actually put a 'block' on baratric surgeries (I hate them-jk). I went to a free seminar on December 8th and scheduled surgery on Dec 28th.

Im 3 days away and super nervous!

It all depends on your tests though. Good luck!

  • Author

Hey - Wow. That is tough. Which tests are you referring to? Do mind if I ask why they turned you down? Or is this an insurance company policy? I am with BCBS (Anthem) Virginia, which covers LapBand as "medically necessary."

My insurance policy has a baratric clause, however, it is only for patients over 55. There is one which allows the surgery for people under 55, but my employer opted to remove it from the policy (to save money).

The testing was just the typical ones-EKG, Blood Work, sleep Apenea Test, etc. It even covered the counseling.

I am in Phoenix, AZ. Is your family very supportive of your decision for surgery?

The time from consult to surgery varies with each situation. The fastest route seems to happen when you are paying for it yourself. Insurance covered surgery can happen in any time from a month to a year. Mine took 7 plus months from free seminar to surgery date. Insurance covered it.

Good Luck!

  • Author

I will have to check the insurance clause. I have only shared the "real" possibility of surgery with my wife. She has seen me struggle with weight for the over 10 years we have been together and is a little scared of this option, but hopeful and supportive.

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