Insurance for corrective surgery

bugsyboy · February 15, 2009

I am looking to get the band "off label", and have a "low" BMI of 31 so my insurance won't cover the surgery.

I am wondering, If there are complications afterwords, swelling, infection etc and I need an adjustment, would my insurance cover that?

Thanks!

Cleo's Mom · February 15, 2009

You would need to check with your insurance company beforehand. You don't want surprises. As with any surgery, the lapband can have complications. But more important, with a BMI of 31 - do you think the band is right for you? How is your eating now? Do you eat a lot of bad food choices or a lot of good food choices (healthy food has calories, too)? Do you exercise? How much weight do you want to lose? With the band and your BMI - you will lose slowly, especially if your food choices are not that bad now. You also have to be prepared to be unable to tolerate a lot of foods: bread, Pasta, rice, beef, pork, ham, raw veggies, popcorn, carbonated beverages and caffeine. I'm not saying you will - but you need to be prepared to not have these. Can you live with that? And you will have to exercise every day for at least 30 minutes. Please do a lot of research before undertaking the band and make sure it is right for you. Good luck.

bugsyboy · February 15, 2009

Thanks Cleo!

My eating isnt great and I think you captured most of what I eat on the list of no-nos! (bread, Pasta, rice, beef, pork, ham, raw veggies, carbonated beverages).

What % of folks aren't able to eat these foods?

I do workout 2-3x a week with a trainer. I was thinking for the money that I was paying him, I could get the surgery and do the workouts myself or see him once a week.

Cleo's Mom · February 15, 2009

Everyone is different with the foods they are able to tolerate. Some can eat bread and Pasta, others can't. Some can tolerate meats, others can't. But you won't know until you have the band. But carbonated beverages are off limits because the carbonation can stretch the pouch. You have to let it get flat before you drink it, if your doctor even allows it then. And caffeine can act as a diuretic. Some doctors allow a little, others don't. Oh, and since pizza has a bread crust - some cannot tolerate it, either. It is a big decision that you have to be prepared to live with. As your band gets tightened you might have more problems with food. Some cannot eat solid foods first thing in the morning. But everyone is different so you won't know how your body will do until you get the band.

tiffanye · February 15, 2009

Have you found a doctor who will do the procedure?

Jaxjulie28 · February 15, 2009

I have a feeling that you might not even find a doctor to perform the lap band. The BMI is so low and from what I have read most won't even do it unless you have a bmi 35+ with co morbidities or 40+ without co morbidities...

Cleo's Mom · February 15, 2009

Those parameters are set by insurance companies. If he is self-pay something tells me he'll find a doctor who will do it. My concern is how much weight he will be able to lose with the band. That's a lot of money to spend for what could be very meager results. My BMI was just below 35 at time of surgery and that was 9/08. I have lost weight because of all the extreme "liquids only" for 4 weeks but have lost only 5 pounds due to the band only. Very glad I wasn't self pay.