Nervous about my insurance approval!

mike324-190
on 12/4/14 7:28 am
RNY on 12/30/14

A couple things: 

 

1) Congrats on your decision to take the next step towards a healthy new you.

2) According to my surgeon, he won't do them ever again. I wanted one, but he too is removing lots of them weekly. So he recommended RNY for me and my situation.

3) I have BCBS of CA and my paperwork goes in either tomorrow or Monday. I too am nervous. Good luck and keep us informed of their decision.

:-)

 

Mike

Hislady
on 12/4/14 7:36 am - Vancouver, WA

I beg you please do not get the lapband!!! I had one for 7 years it has caused permanent damage to my esophagus and I am far from the only one! I belong to other forums beside this one and there are 2 women I know personally that have lost their entire stomach from damage caused by the lap band. Even the Mayo Clinic which is one of the finest medical facilities in the country will no longer put bands in! They are the very least effective form of weight loss surgery, only 50% of people will lose any weight with one and only 25% will lose and maintain that loss. It causes severe damage to the stomach and esophagus resulting in constant GERD and reflux problems. The band is a nightmare waiting to happen it is just a matter of time for the majority of us. I only know 2 people who have had any long term success with their bands but it still goes back to them watching diet and exercise. Please continue researching all the weight loss surgery options but please don't get a band!!

Mary Gee
on 12/4/14 7:38 am - AZ
VSG on 05/14/14

Keep doing research before making your final decision.  You'll find more and more surgeon's are not doing lapbands (other than removing them).  The final choice, of course, is yours.  Use the search feature at the top of the page (the magnifying glass). Also, check the Revisions board.

In regard to the last requirement (failed all weight-loss attempts, etc.), every insurer is different.  My company accepted a letter from my PCP, who supported the WLS.  He has been my PCP for years.  He submitted a letter stating I saw him on a regular basis over several years, I attempted several different diets, and he provided my weight history.  But other companies require you follow their weight loss plan -- call your insurer for clarification, or check your policy on-line.

Best of luck to you.

       

 HW: 380 SW: 324 GW: 175  

 

 

 

 

 

 

 

(deactivated member)
on 12/4/14 7:55 am

I will have BCBS of Il beginning Jan1.  Were you required to do a diet plan?

ladygodiva1228
on 12/4/14 8:25 am - Putnam, CT
Revision on 02/04/15
On December 4, 2014 at 1:40 PM Pacific Time, Amber K. wrote:

So I've started going through the initial stages for lap band surgery but I am so nervous my insurance company will deny me. My BMI was 40.1 (I’m about 120 lbs over my ideal weight for my height), suffer from ankle pain, and I have high blood pressure that causes really bad migraines. The dietician, psychologist and physician all three said I'd be a good candidate and that I'll require little behavioral modification since I'm constantly on a strict eating habit and I'm relatively active.

My paperwork is being submitted as soon as they receive the write up from the psychologist (should be before December 18th). BUT ... I am so nervous my insurance company will deny me for some stupid reason. My insurance is Blue Cross Blue Shield of Illinois, their requirement is :

  • You are 100 pounds or more above ideal weight, or
  • You have a Body Mass Index above 40, or
  • You have a Body mass Index of 35 or greater and suffer from medical problems associated with obesity such as coronary heart disease, type 2 diabetes, sleep apnea or hypertension.
  • You have been overweight for at least five years, and
  • You have failed all weight-loss attempts including diets, exercise and weight loss programs.

Anyone else deal with Blue Cross Blue Shield of Illinois? Good/bad experiences?

If I were you I would go with the sleeve. 

I just came from my surgeon who will be doing a lap band to bypass revision for me.  After 11 years the complication I am having just suck. 

Most good doctors are no longer offering the band and I have heard that some insurances are starting to faze them out as being covered because of the long term complications. 

I know it is ultimately your decision, but think about this how many WLS do you want to have?

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

Elegantchic82
on 12/4/14 9:00 am
RNY on 12/29/14

Hey, praying you get the Answer you want b/c I have Bcbsil and I was approve!!! My surgery is 12-29!!! I started everything towards the end of sept and look where I am now, SUPER EXCITED!! But the best of luck to you Dear!!

Amber K.
on 12/4/14 9:10 am

That's awesome! What kind of criteria did you hit (if I may ask) and did they give u any trouble?

Elegantchic82
on 12/4/14 9:50 am
RNY on 12/29/14

Well I know my BMI, only hit 40 once but I stay at 38-39. Since I was diagnosed with diabetes and been did a sleep study that was good enough for them, and my surgeon required 3 years weight history. I pushed hard for this because I wanted it done before the new year!! My paper work got submitted on 11-11 and got my approval on 11-24, and everything went thru without any problems!!

Amber K.
on 12/4/14 11:00 pm

Thats fantastic! Please let me know how it all goes for you! I'd be really interested in following your journey ^_^

Han Shot First
on 12/7/14 10:30 pm - Flint, MI
RNY on 10/06/14

It sounds like you should be all set with the requirements. 

I understand the desire to have the lapband, since it's the least invasive.  That's what I started looking at originally, until I saw the poor track record.  I ultimately went with RNY because it gets results.  Also, I like that nothing is actually removed with RNY.  It can be reversed (although it is not easy, and from what I have read on this board, it is not done by many doctors.  Still, it's possible at least.). 

But of course, there's plenty of great reasons to go with the sleeve as well.  Ultimately, you'll (probably) do much better with either RNY or sleeve rather than lapband.

--

150 lost and maintaining!

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