Hey all.

I just wanted to introduce myself.

My name is Jessica Kolman. I live in Raleigh, North Carolina and I'm 24 years old.

I'm 5'3'' and 235lbs.

I've struggled with weight loss for a short time, but I feel like I can't do anything. I've done gym memberships and went to the gym at least 6 days a week. I didn't lose much weight at all. I lost maybe 10 pounds and never went below that.

I'm a vegetarian and so my eating habbits are very selective but I tried to make them healthy.

I even tried the Alli pill but that didn't do much even when I stuck to the plan.

I feel helpless and I don't know what else to do.

I honestly think that this may be the key. I know that with the Realize Band Surgery that there are going to be risks and downsides, but I'm willing to take the chance. I know that I'm going to not only change my eating style dramatically but work out a lot more as well.

I went on the REALIZeBand.com website and I do qualify for the surgery.

I plan on attending the seminar in September with my husband.

I just hope that my health insurance can cover most if not all of it.

I have Blue Cross Blue Shield.

I'll keep you posted on what I do.

Which BCBS do you have? Which state, and PPO/HMO, etc. Do you know your insurance requirements?

I am planning to get the Realize band very soon too. I have BCBSIL and working through their requirements right now, but hope to have my band in sometime this fall.

Good luck

Amy

I have Blue Cross Blue Shield of North Carolina PPO. I went to the website and they say they cover the surgery. But what do I do to find out if they cover the surgery for me?

I have Blue Cross Blue Shield of North Carolina PPO. I went to the website and they say they cover the surgery. But what do I do to find out if they cover the surgery for me?

I'd start to research the insurance forum here. That is really where I found out most of my insurance requirements. I know that people aren't always a reputable source, but if 3 different people are saying the same thing in 3 different posts, it's probably right.

Good luck!

I will look into those forums about insurance.

I think it would be good to look at the Insurance forums here, but the overall best thing is to contact your insurance company--either call their number on the back of your card or look at their website and they should be able to mail you the exact requirements. Here is the link I found that states their info, but I would still call to double check:

https://www.bcbsnc.com/services/medical-policy/pdf/surgery_for_morbid_obesity.pdf

The reason I asked who it was, is b/c I have BCBSIL and have to complete 6 months of dieting/exercise with my Primary Care Dr before I can attempt to get approval. Lots of insurance companies do this, so that seems to be a very common starting point for most people. However, I did not see that in your policy, but like I said, I would check with them for exact policies...

Good luck in your WLS journey.

Amy

hey jessica, welcome. I have BCBS and can tell you if you *do* have BCBS and you have PPO you have to do a 6 month supervised diet, if you have HMO its usually approved. Realize is the newer band. They recently made it a bit smaller I believe, and also took out the name "lap" from the lap band. Once you get the doctor approvals (cardio, respitory and psych), then its usually smooth sailing from there. However, Lately I've heard of ppl going to a nutritionist. That part is a bit new for me. Ive found out recently hanging out in the chat room here on the website also is very informative once you find "chatty" ppl lol..I wish you the best

what would you consider a "6 month supervised diet"? I'm confused. You mean like weight watchers online or does it have to be at meetings? I jus don't understand that part of it.

What would be my first step of doing this? Who do I talk to ??

It depends if you have BCBS PPO...nothing like weight watchers..its like doctor prescribed. First you want to find out if you have PPO or HMO. Do you know which you have?

PPO health insurance

ok, so you can do one of two things. you can do the 6 month supervised dieting (your doctor that you go for the consultation will help you with that). Or you can do what i did. at open enrollment, i changed to HMO, and was approved almost immediately. My open enrollment was in december. yours may be different..find out from your job...it'll be ok.

I found out that I had a realize band installed in me in June. I was banded 1/15/08. I wish I had known sooner. I registered with RealizeMySuccess, this is a great site. Have someone help take down your measurements & log them in. Lap-Band also has a site. Both have phone numbers you can call. On some of my other posts I have info on realize. Women should get measurements pre-op. I lost a combined loss of 24 inches since May. I lost a bothersome burdening 127 pounds of fat & torture. 52 to 36 BMI. I have not had a fill yet. Exercise, eat correctly & go to support groups. For me I feel that I've made a large down payment on 10 or 20 years of Quality Life in the last 7 months. Losing my ass in Vegas & Loving it. Hasta Pronto, George:thumbup::thumbup:

What is the difference between PPO and HMO ???

I'm not very familiar with that.

As a matter of fact I'm going to be starting a new job in a week. The health insurance that I have with the job now is going to be pretty much the same, but I will be starting new insurance policy. How does that work?

I found out that I had a realize band installed in me in June. I was banded 1/15/08. I wish I had known sooner. I registered with RealizeMySuccess, this is a great site. Have someone help take down your measurements & log them in. Lap-Band also has a site. Both have phone numbers you can call. On some of my other posts I have info on realize. Women should get measurements pre-op. I lost a combined loss of 24 inches since May. I lost a bothersome burdening 127 pounds of fat & torture. 52 to 36 BMI. I have not had a fill yet. Exercise, eat correctly & go to support groups. For me I feel that I've made a large down payment on 10 or 20 years of Quality Life in the last 7 months. Losing my ass in Vegas & Loving it. Hasta Pronto, George:thumbup::thumbup:

I will look into that other website as well. Wow that is awesome!! Congrats! How much did you have to pay for a co-pay? Just curious.

with PPO you can go anywhere in the network and no co-pays. with HMO you have to get referals (which are written requests basically) from your primary care physician. A referal can take about 5-7 days. So, lets say I have HMO and I go to my doctor and i say "i want to go to my BMI surgeon, I have a consultation." I have to go see my doctor, get a referal, and THEN go see the surgeon. Thats how it works with HMO.

Re your new job: Find out about the benefits. Most new employers and health insurance companies have a waiting period ( I actually work for BCBS..i know what im talking about). for example, 30 days, 90 days etc. before you can become "eligible" or able to take their benefits. some are immediate.

I agree with the Previous poster, however, just to clarify, although there are no copays with PPO, it can be deceiving, b/c you still most likely have to meet your deductible. In my case, I have an out of pocket cost of $2500 before insurance kicks in, so although I don't have an actual "copay" it is still a load of $$. Insurance is complicated.... :thumbup: Good luck!

Amy