Feeling Let Down: My first post

NJChick · September 20, 2005

When I went to my surgeon for the consultation I thought to myself I should have brought pictures of me since I was 6 years old, isn't that proof enuf.

Its a shame that the insurance company wants 5 years of a doctors assisted diet, thats stupid. I don't know a single over weight person who doesn't keep trying to lose weight.

I hope you'll fight them.

HUGS !!!

PinkMary · September 20, 2005

i do not want to .."advertise" my surgeon but im speechless about the price of the surgery in States & Mexico! OMG thats astronomical prices!

my band and the surgery costed to me 3.500 euro .. almost 3.500 $

(hospital, surgeon, anaesthiologist + tests + free fills for life!)

and i still believe i paid too much...

tinalondon · September 21, 2005

I had the same thing, but have your doctor check your medical chat with your g.p.

I'm sure he has put down your are over wieght. If so you in...you need him to send a copy to the insurance saying he has been trying to get you to drop some weight.

Poodles · September 21, 2005

Good news for Teacher! If you are on that horrible TRS Activecare through BC/BS offered to TX teachers then I have good news for you. In my ISD three people have been approved and have had their surgeries. Two bypasses and one band (so far). I am watching their progress now. The lady with the band just had to show Dr. monitored diet for one year.

So there is hope, if you meet the other requirements.

babsintx3 · September 21, 2005

Hi Affy,

No need for you to go to Mexico to have this done. You are in the heart of the 3rd largest lapband market in the US. There are surgeons right here in your neck of the woods that will band you for 10K. There is also medical financing available if you have good credit.

Babs in TX

334/189/170

-145

Danistar · September 24, 2005

Hi

My advice is don't give up as well! My Bariatric surgeon had me fill out two complete pages of information regarding my weight loss efforts. This was very complete...I went year by year and all of those efforts really added up. There is always another way. Also I had to have a letter from my doctor which stated how many weight loss efforts I had made over the years, what my co morbities were, and that he felt that I seriously needed the surgery.

Does your surgeon do any help when an insurance company turns you down, or haven't you gotten that far?

I went to a seminar and learned all of the ins and outs, and the Dr told us that his office would do everything they could to get it covered. Maybe if you find the best surgeon in town he will do this for you and help you to fight.

Realistically any insurance co should be willing to, if you have most of the co morbities and you list in the letter all of the drugs you are taking.

Please let us know how this turns out.

And yes there are always the surgeons in Mexico, but a little wrangling with the insurance company might work. I think there is a whole thread on this.

good luck

Zoe · September 28, 2005

Affy, you've gotten some great advice here, including tips from Texans. I agree that you should talk to your doctor and see what he can do to help document your weight-loss attempts. Complete all the effing forms for BC/BS -- and if they turn you down, appeal! And remember that a lot of us with modest incomes found ways to finance the band surgery outside the US, if it comes to that. (I used a home-equity loan.) Good luck -- don't give up!

flygirlincolo · September 30, 2005

I have blue cross blue shield and they paid for my surgery..I just had to give a log on the MANY MANY MANY diets I have tried and boy there was a list!!I didn't have to have documentation when we submitted it, my surgeon just wrote a really good letter stating all of my conditions, all my failed attempts at wieght loss and they covered it tottally!!

so keep your chin up and submit that paper work, you will be very surprised I am sure!!!

Carrie

Dianechef · September 30, 2005

You're the DADDY!!! Very cool - I am even more impressed. To answer your question about the fills: YES, I went to MX to get my first fill. However, you do not have to. There are nearby doctors who can give you fill in your town. I wanted to get my first fill by the doctors who did my surgery. It was only $100 & they did it under floro. I have only had 1 fill & they hit the SWEET SPOT!! I am very happy I went back.

Good luck on your journey! You can do this!!