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I have questions...

I am actually starting my journey and will be attending my first seminar on Friday. I have come across this forum while trying to get more information. I have a question regarding the process. Some people have said that it has taken a long time to get their actual surgery date. Does anybody have any insight as to how long the starting process can be before getting your surg date?

I ws also wondering if anyone out there has Perferred One health ins and if they got it covered?

Please help the newbie1:unsure:

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Some insurance requires 3 or 6 month doc supervised diet and exercise, before they will pay for a band. Some never pay- no matter what.

I had no insurance so I went to seminar did my doc required stuff and was banded in less than 60 days.

I began my journey in Feb 2007 with my first seminar and consult. I was finally banded May 31, 2007 after my insurance denied me and I had to appeal which they finally approved. Like the others have said, self pay goes quick. Insurance usually takes 3-9 months especially if you have to do a 6 month suprevised weight loss plan. Good luck!

Like everyone said before, it really is whatever your insurance requires as pre op. Mine only required 2 nutrition classes and 2 support groups. All of the other appts really depend on the center you choose and what they require like cardiologist and pulmonlogyst. both of which sent me for extra test so that made it a bit longer plus all the classes were on days i work so i had to make arrangments to get off blah blah. so far my seminar was jan 10th and i only have to wait for my pulm clearance and all those test are done so I'm looking at late april early may for my surgery so about 4-5 months. again you should probably call your insurance company and ask them if they cover it and what % and what the pre op requirments are. I just found having all my insurance information before my seminar made it better plus without insurance there is no way I could get this done so I had to call before I even wasted my brain power on the thought.

good luck I hope everything works, and I know right now you just want to have it done cause I do too, but no matter how long it takes to get it I know in my heart it will be worth it.

My insurance was good about covering it and I more than met the criteria. I was banded a month after attending the seminar. I was able to skip certain tests because I had just had a physical and they already knew I had sleep apnea, so it might have taken an extra couple of weeks otherwise.

My insurance did not require physician supervised diet to prove anything though.

I have Providence Health Plan and my insurance was quick to approve, though the whole process took about two months. It seems that each surgeon is a bit different, though many seem to require what I went through.

Information seminar

Lab work

Nutrition Consult

Physical

PT consult

Psych Eval

sleep study (HUGE waste of time, IMHO)

Surgeon consult

Insurance approval (mine took two days. Seriously)

Pre-op apt

Milk diet (or some form of pre-op diet... mine is two weeks)

Surgery date

So even throug self pay it can take a bit to jump through the hoops. It largely depends on appointment availability and finding place in the surgeons busy schedule.

Best of luck to you!

It totally depends on insurance. I was self-pay so I went to my seminar in August and had surgery in October. Very quick because I didn't have to wait for approval.

First I would call your insurance or pull out your hand book. All of the companies will tell you if they cover it and if so what the requirements are.

I had to have a BMI of 40 or more and 0 comorbities or less than 40 with 2. They also required me to complete 6 appts with a dietitian over a 6 month period (Last one in 9 days!), a phsyc eval, blood work, and surgeon required me to lose 10 pounds.

I have BCBS of Minnesota (even tho I live in oregon)

So they are all different you just have to look into it.

I was self-pay and I was banded about 45 days from my first seminar.

My insurance is Aetna, I'm currently working on my 90 day dietician supervised diet program. I'm trying to get all my bases covered before I'm finished. I just had a sleep study and I'm going to be scheduling lab work/chest x-ray when I see my doc this week. I figure, as much as I can get done now makes things that much quicker at the end of my 90days.

All insurance is different, my friend had her surgery booked and done within 1month of her seminar, but she didn't have any pre-req's besides her BMI.

I'm in the middle of the process too... My first seminiar was the very end of February... After trying to schedule everything and wait for appointments... It's going to be around 3 months... I'm hoping for an early to mid May surgery!

Good Luck,

Shannon

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Thanks for all you imput. I guess I never stopped to think about how this was all going to work out. They did ask me to bring my insurance card to the seminar so I am hoping that they might have an idea of what my insurance requires. I am so hppy that I found this forum. :)

Just an idea but on the back of your health insurance card should be a customer service or information number you can call and you can specifically ask if they cover adjustable gastric band surgery and if so, what are the requirements to qualify. My insurance was Aetna and the phone representative let me know if my company's plan covered it, and then directed me to the web site page on the details of what the insurance requirements were. So, I always try to advise people to first find out if insurance covers it by talking directly to your own insurance company. I've seen a couple cases where folks went to the seminar at one weight loss center, fell in love with that program and were well into planning to have their surgery there, and then found that the only bariatric center of excellence on their plan wasn't the one they had been working with and they had to start over with the bariatric surgeon that was In-Network for them.

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