I have BCBS of Texas Active Care (am a teacher).

Everything, including BCBS indicates that the lap band is covered as long as I jump through the hops. I went to TLC Edge today and was extremely discouraged because

a) I was the largest I've ever been according to the scales.

:eek: The PA came across as an idiot.

Though I figure I might as well keep jumping through through the hoops, as it will be easier to decide not to do the surgery than it will be to stop and start again.

Anyone else at this point? It would be nice to have a friend -- or someone a bit further along.

Hi Beaglemom,

In March I started this process. The medical group I was with told me first that they didn't have anyone in my area who did the lap band surgery, then that they wanted five years proof of attempted weight loss, then that they wanted a psychological evaluation, then office notes from my doctor, then just six months' proof of attempted weight loss. I wrote letters, jumped through hoops, did the cardiology exam and the psych eval. In October, I went to see my primary care physician and found out that the medical group I belonged to was "bought out" so I was switched to another one, which approved my initial consultation with the surgeon within three days. Believe me, I understand what you're going through, and it's probably not over, because after I do all this, maybe the psych eval and the cardiology exam again, I'll still have to wait for approval for the surgery! It feels good, though, when things finally get going, and I won't mind redoing stuff if I have too.

Good luck, and hang in there!

Debbie

Thanks for responding. Hopefully my medical group is stable though they seemed to be in a "store front" yesterday.

I have BCBS of Texas Active Care (am a teacher).

Everything, including BCBS indicates that the lap band is covered as long as I jump through the hops. I went to TLC Edge today and was extremely discouraged because

a) I was the largest I've ever been according to the scales.

:laugh: The PA came across as an idiot.

Though I figure I might as well keep jumping through through the hoops, as it will be easier to decide not to do the surgery than it will be to stop and start again.

Anyone else at this point? It would be nice to have a friend -- or someone a bit further along.

I have BC/BS of GA. I agree u will jump through alot of hoops. Sometimes it feels like I am the one doing all the work. Now I am waiting on my approval from the insurance co. It was sent off on Nov.4. Just please check behind them especially with what the ins. covers. At one point I thought I was actually finish with everything I even called and ask if there was anything else and they said no. then they call and said I needed an upper gi. So i had to do it. Take off work again . I started off with TRUE RESULTS. For that all I have to say is, call ur ins. co and find out what u have to do yourself. You get better results.

Hi,

I am starting the process finally. And yes it is a process for sure! Over a year ago I started it and stopped. My friend continued...she ended up getting the sleeve but I look at her now and the time I wasted......I could be there by now!!!!

My story is a different journey as I do not qualify for my insurance at all. I have a BMI of 33 and they won't even allow me to do it. So self financing is my option. I have 4 months until I am debt free and will be able to get a cosigner for my lap band. It is worth the work to stick it out and push through. Having insurance hoops are hard I know......but stick it out! Don't waste away a year of your life like I did!

Hang in there!