Insurance companies?

Hello all. I am new here and have my semnar next saturday. SO my question is do all insurance companies make you wait 6 months before the surgery? I have bluecross ppo. Thanks for any info

Actually, each company is quite different. My insurance company really only looks for a BMI over 40 and one co-morbidity or a BMI 35-39 with two co-morbidities. Your individual surgeon will probably have someone in her or his office that can help you navigate the insurance obsticles. Obvisouly, it's in the surgeon's best financial interest to help you get the surgery.

I forgot to answer the basic question. NO, not all insurance companies expect you to be on a diet for 6 months.

Each insurance is different...

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No not all insurance carriers require 6 monthes. I have aetna epo and it only requires 3 monthes. However I did not loose my required 15 to 20 lbs before the 3 monthes were up so i chose to go another month until i reached it just incase! Went through everything and see my surgeon on monday for a last visit before my operation on july 29th. Cant wait....Finally here! WOOHOOOOO!!! Best of luck to you!

I have Blue Cross PPO and they denied me didn't have a high enough BMI and only 1 co-morbidity my doctor even challenged to decision because I have sever sleep apnea in the REM stage but they wanted me to use non-surgical treatments. I opted to go self-pay.

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Band Date: May 13, 2008
Average weight before surgery: 197
Current Weight: 159
Self pay $14,500:Dr Helmuth Billy of JourneyLite

I have Blue Cross Blue Sheild PPO (federal employee). I called last week and my policy does not require any period of time under supervised weight loss. It also does not require a specific amount of weight to be lost before approval. It is also covered under my policy. Just in rough calculations I figure I'll be out $2,000 or less. Much less if copays only apply. I am going to my seminar at St. Mary's in Louisville KY on July 22nd. I'll be seeing Dr. Lusco, with LAP-BAND® of Louisville.

I, too, am just beginning this journey. I am 34, married to the most wonderful man for 10 years and have two beatiful sons 7 and 4. I have been overweight since I can remember. DH has never even mentioned my weight. I literally fear for my life if I don't get the weight off. I have tried so many different things. I reason I fear- My father, now 57, had his first heart attack and open heart surgery at the ripe age of 40. I can remember as if it were yesterday. I was a freshman at Western Kentucky University (18 yrs old). Since then he has had numerous stints. My grandmother (his mother) died in her sixties with heart disease. If I were to follow close to 40, my children would be so young. I do not want these years taken away. Currently, BMI is 41.2. I have also went on meds for High BP last December.

I think that I have made the right decision. I have prayed about it. I was about to settle for a doctor that was closer, however, as it would be He was not PPO and I could not find out much about him or his firm. I hear so many good things about Dr. Lusco. I am fired up and ready to get started.

The best part of the whole thing thus far is that my husband is behind me. Yeah!!!!

I believe that God's gives each of usspecial talents. I am truly thankful that God has blessed these doctors with such talents and are able to help us.

Self-pay here. I have BC PPO-Alabama (each state and policy is different). The insurance companies make it so hard...however i've read so many post where insurance companies have came through. With that said there seems to be just as many self-pays. I'd like to know the ratio between the two.

I think the insurance companies realize that when they turn down...thats not the end for many. A lot of people will get it done somehow, if they really want it bad enough. So they're, the insurance company, is in a win-win situation.
They don't have to pay but they get a healthier client whom uses their insurance much less. It really stinks.

sincerely,
the insurance agent

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Banded 02/28/2008
Dr Britt

Thread Starter

Thanks everyone for your input. I live in California and have a pretty good insurance plan. Its with the movie studios. But I am so scared I will be denied. If I am then I will have to wait 2 years when my car is paid off. But if it is meant to be then so be it. All of the stories on here are awesome. I hope everyone keeps up the good work and hangs in there.

carolyn

I have Humana and it sucks. They only cover a max of $5,000 so I would have to come up with the other $10-15-20,000!!!!! AND they require all the preliminaries of 6 months of everything...dieting, counseling, etc. I've got that pretty well covered as I've tried EVERYTHING to lose weight. My primary doc says LAP-BAND® is the answer for me...I'm diabetic, BMI of 48, sleep apnea (though not actually tested/diagnosed), swelling of legs and feet, and finally, chronic lower back pain that I'm getting epidural shots for (UGH!) etc., etc. It's so not fair and I'm so discouraged.