AR Teachers wanting Lap Band

lo2us · 03-15-2007, 09:14 AM

I went to a Seminar on 3/13 and found out that AR teacher's insurance won't cover the surgery. :angry

I'm curious if (and how many) there are other teachers in AR who are interested in having Lap Band surgery. I think we should all be writing letters to the Governer and out State Reps. to find out why 70% of insurances cover the surgery, but our insurance doesn't! Please post and let me know if you're a teacher and would like to change our insurance!

ouachita · 03-15-2007, 12:06 PM

It's not just teachers. I work for Arkansas too and had to self finance my banding. I don't know about all the available plans through the state, but QualChoice has a specific exclusion for bariatric surgery.

I find that particularly ironic given Mike Huckabee's crusade against obesity. Of course if I were the governor and had someone to custom prepare and pack all my meals for me as well as access to UAMS weight control programs I guess I wouldn't need the band either. I doubt it will be any better under Beebe, but I guess we can always hope.

I wounder how many politicians have had WLS of one form or another on the QT in order to maintain or improve their public image?

lo2us · 03-15-2007, 01:20 PM

I guess this shows us how most of our politicians and policy makers feel about state workers!

ouachita · 03-15-2007, 11:53 PM

Yeah, can't you just feel the love?

WASaBubbleButt · 03-16-2007, 12:20 AM

The private sector is no different. I paid cash for my procedure as have many many others. ALL people that went to Mexico are a pretty good example.

lo2us · 03-16-2007, 08:45 AM

So where are all these folks that have that 70% that WILL pay for this surgery????

WASaBubbleButt · 03-16-2007, 12:39 PM

Keep in mind, there are a TON of people that have no insurance. That 70% stat wouldn't cover all those folks. That probably brings that 70% figure of who has coverage for obesity down to about 30%. So all in all, at least you have insurance.

I'm not being hard hearted here, just realistic.

I've seen people write about getting 2nd and 3rd jobs to pay for banding, one girl sold her home to take the equity, people get financing and pay 19% interest, my friend used her savings (as did I)... the list goes on.

lo2us · 03-16-2007, 03:02 PM

You're right, I just figured that since I'm paying $325+ a month for coverage that it might actually pay for something that I really need. Everytime something major comes up they back out or tie it up to where it takes so long to get it approved, you give up on trying. and take your chances.
At the moment, I'm entertaining loans just like everybody else.
It's just disheartening. Even if we were able to get the policies to change, I'd like to have the surgery before they'd have it all mapped out. I hate for others to have to go through all this, when it's something that can save lives! So I'm going to keep trying to make the policy makers aware for the rest of the school year. I'm just sick of all this sorry insurance I'm paying for!

WASaBubbleButt · 03-16-2007, 05:18 PM

I understand what you are saying. However, if you are paying $325 out of pocket in addition to what the state pays, you can probably get a better deal getting your own policy.

Besides, premiums that cover bariatric surgery are in addition to what you are already paying.

Actually, my insurance would have covered a portion of my surgery but with my deductable and copay, it was only a couple of thousand more to go to Mexico and in Mexico I didn't have to jump through insurance co hoops. No sleep study, psych eval, nutritionist, six month medically supervised diet, none of that nonsense.

I did my research, finally picked out the surgery type and surgeon and the day I made those decisions I schedule surgery for six days later. If I had it all to do over again I'd do it the same way.

Keep in mind, even if your insurance does change to cover bariatric surgery there could be a 1 year wait FROM THE TIME THE POLICY CHANGED to the point it would be covered. And THEN the six month medically supervised diet, etc. It all depends on the insurance company. So even if it did change, you could potentially be looking at an 18 month wait.

Another point, many ins co's will cover bariatric surgery but not the Lap Band. Just because 70% of ins co's pay for surgery doesn't mean they pay for the Lap Band. TriCare is an example, they'll pay for bypass and that old crappy band that is not adjustable AND they cut out half your stomach but they won't pay for Inamed's band. So that 70% is misleading in a lot of ways. :cry

freeradical · 03-18-2007, 08:01 PM

I work for the state and have Qualchoice QCA at UAMS. Our ins. will not pay for anything to do with weightloss. Not programs, not surgeries, not counceling- NOTHING. They do support a healthier life style through weightloss, but that's as far as it goes. Oh wait, I forgot we do have some psych ins. We can go to into therapy to lose weight until we max out that. The employees do not even get a discount to participate in the Kern's weight loss program at VA/UAMS that our previous illustrious Governator lost all his weight on. I believe the state residents paid for that along with the chef that prepared his meals, so he didn't exactly need insurance.

I pay monthly premiums for my health insurance along with an additional $300.00 a month on my credit card for my Lap Band surgery. My interest rate on that is going up in a couple of months from 2.99% to over 13%. At the Lap Band seminar they said I can claim the expense on my income tax. I did and got maybe an additional $3,000 back of the $16,000 I charged, and my accountant said I can also expect to be audited. I'm a little apprehensive about that, however, I do have receipts. Hate the audit idea though. To add insult to injury I have only lost 25 lbs since 7/06.

Take from this what you will. I'm not angry or anything. This just really sounds funny to me once I sat down and actually put it in writing. Hum, I've gotta wonder here. I think I just had my reality check.
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freeradical · 03-19-2007, 09:48 AM

I'm having trouble staying on a diet same as before the Lap Band.

Lap_dancer · 03-19-2007, 09:54 AM

Quote:

Originally Posted by ouachita

It's not just teachers. I work for Arkansas too and had to self finance my banding. I don't know about all the available plans through the state, but QualChoice has a specific exclusion for bariatric surgery.

I find that particularly ironic given Mike Huckabee's crusade against obesity. Of course if I were the governor and had someone to custom prepare and pack all my meals for me as well as access to UAMS weight control programs I guess I wouldn't need the band either. I doubt it will be any better under Beebe, but I guess we can always hope.

I wounder how many politicians have had WLS of one form or another on the QT in order to maintain or improve their public image?

I think that is a good platform to start from.

My district insurance committee went to BCBS and asked for the purchase of a rider to my plan. At the time, the rep. was SURE OKAY NO PROBLEM but three weeks later he said it was a no go. That we were "fully insured". So it wasn't my school district's fault, it was the putz (plural putz) at BCBS.

Good luck!

lo2us · 04-11-2007, 09:04 AM

:update: For those of us who are members of the NEA and are trying to figure out how to pay for this procedure, we can get personal loans and lines of credit through the NEA right now with the lowest APRs I've been able to find in the past month and half of research!

Go to www.nea.org to find out more.

tehudson · 04-25-2008, 10:14 AM

I am a state employee, and my wife works for the City of Little Rock. I went to Mexico for lap band surgery and paid for it using our flexible spending accounts. I contributed $4000 to my FSA; my wife contributed $5000 to her FSA. The surgery cost was $8500. Certainly not as good as having insurance cover it, but the money I spent was tax free.

freeradical · 05-14-2008, 10:01 PM

where do you go for your adjustments and how much do you pay for each one?