1st meeting with surgeon; afraid about insurance

mickeymammoth · June 4, 2008

Hi All,

I finally had my first appointment with my surgeon (Dr. Snyder in Denver). It went great, he was really nice. He talks a mile a minute, but in a good way. He seems like someone whose brain is always working. He summed up me and my life pretty well based on some observations; either that, or he says the same things to everyone!

The best part was when he looked at my psych eval, and I got a "Good" rating on it. He says that particular psychologist almost never gives a Good rating to anyone (Fair if you're lucky), so I must have done something right there!

I asked him about the Realize band vs. the Lap-Band, and he had just finished training for the Realize band and thought it looked like a good product. He has TONS of Lap-Band experience, and he thinks it's a great product, but he was totally open to trying the Realize one too. We'll see what he thinks of it after he installs a few...

Then I went and talked to the insurance lady. I was dismayed to find out that they were going to submit my weight from today. 2 months ago, after I weighed in at my regular Dr., I set the lap-band journey in motion. But I couldn't get in to see him for 2 months, so I decided to start dieting right then rather than live any longer at that weight. Well, now I've lost almost 20 lbs., and am a 37 BMI instead of a 40 BMI, and I'm worried that insurance is going to balk. I have sleep apnea, and I have high blood pressure, cholesterol, and am pre-diabetic. But she said pre-deiabetes and high blood pressure don't count to insurance unless I'm taking medication. So I guess I have to see how mean insurance is going to be... Or maybe they'll be cool and approve me. Sigh. If I had known that I had to maintain 40 BMI until I saw Dr. Snyder, I might have not dieted...

Life would be WAY easier if insurance pays.

Jameskc · June 5, 2008

I'm in the same boat. My surgeon's insurance corrdinator told me to pre diet for six months, but to make sure I didn't lose any weight. I'll tell you what they told me. Just jump through the hoops, go on the doctor supervised diet, but make sure you are still heavy enough when the time comes to submit the insurance proposal.

mickeymammoth · June 30, 2008

Good news! I just got my approval letter from United Health! I was like, "Yay!... Uh oh." It all just got a whole lot more real. I wasn't able to get through to the surgery scheduler today, but hopefully soon I'll have a date. Eeek!

ocbreeze4u · July 1, 2008

Some insurances accept sleep apnea as a co-morbidity but all accept diabetes as a co-morbidity (but not pre-diabetes). I only have a BMI of 36.9 however, I am diabetic so I qualified with Aetna PPO. There are ways of increasing your sugar levels during a 4 hour blood test so you will come across as diabetic...if you are interested then send me a private message and I will tell you how:wink2:.