helpppppp please

wa107901 · 06-04-2009, 08:19 PM

Hey all umm basically have a couple questions for anyone who can answer.okay so number one I have insurance through my work and its aetna open choice ppo well I called customer care and they said that they don't cover the LAP-BAND® surgery well okay fine right... So I called again just to clarify and still no anyway I have been doing a lot of research online about the procees and basically it said that I could appeal well I went home and found my paperwork from when I initially got my insurance and anyway umm I read every paper I had and basically I had to throw the idea of an appeal out because the very last page I read said don't cover weight loss surgery whether a doctor recommends it or not...so good thing I didn't start that process. Anyway well I want to know how it feels to have the LAP-BAND®? Does it work well? What insurance company and exact plan did any of u have that covered the procedure and how much did it cost out of pocket? Was it worth it? What pre qualifications did u have to have? Mainly the insurance

Brockbabe82 · 06-04-2009, 08:25 PM

I have federal blue cross blue shield. I had to have a bmi over 35 and have issues related to my obesity. I had things I had to do for my surgeon but nothing that affected my insurance. The overall cost out of pocet besides my copays for doc visits, was $145.00 which was basically just for the anesthesia (spelling?) . I am so happy I made the decision to have this done, it has been 100% worth it. Although there are tough times, it is so worth it to get my life back. Good luck to you, keep your head up.

wa107901 · 06-04-2009, 09:02 PM

Thank you for your help I appreciate it. My bmi is 35.5 I have high blood pressure and fibromyalgia and I know my weight contributes to fibro pain and my blood pressure as well. May I ask one other question as to how much was your deduc

Brockbabe82 · 06-04-2009, 09:11 PM

my deductable for my familys insurance is 4000, so we meet that very fast. I believe for me it was 1800. Everything was basically 100% covered but I met all the criteria. Check out the insurance and billing piece of this forum they have a info on the different insurances and costs.Good luck to you hun.

wa107901 · 06-04-2009, 09:13 PM

Thank you tonz

Brockbabe82 · 06-04-2009, 09:16 PM

no problem I hope you get it all figured out!

nwlife4 · 06-04-2009, 09:52 PM

For myself I wasn't covered under insurance either so I self paid - I used Care Credit - My surgery was done in Detroit, MI which is one of the cheaper places I met patients that came from as far as AZ-at the time it was $12,000 now I believe it is even cheaper. That could be an option for you though. I would pay it over again if anything ever happened I will always be with my LB I love it. As far as how it feels? You feel normal except you are full fast...which u then don't eat a lot. One thing is you have to get your fills until you reach your sweet spot (which is the where you are comfortable and full faster but able to swallow w/o vomiting- when u reach it that is when It all begins life changes as u know it! This has truly changed my life.... No more tv for me..... now I love to play basketball with the family, ride bikes, go to the beach , live life without being afraid b/c of my size. No more back pain either!!!!!! And also since I was self pay I didn't have to do any pre surgery visits I just called and 2 weeks later I was having the surgery.

wa107901 · 06-05-2009, 08:42 PM

Thank you for everything...now u said u did self pay and I'm just curious I'm 19 and my credits not too high. Did you have to have good credit for that carecrdit? I think that sounds like a great option for me I just need to know what hoops I have to jump through for each option. Are payments pretty high up there? Did that include airfare? Also about the procedure did you loose pretty fast ?

Thank youcomfortable and full faster but able to swallow w/o vomiting- when u reach it that is when It all begins life changes as u know it! This has truly changed my life.... No more tv for me..... now I love to play basketball with the family, ride bikes, go to the beach , live life without being afraid b/c of my size. No more back pain either!!!!!! And also since I was self pay I didn't have to do any pre surgery visits I just called and 2 weeks later I was having the surgery.[/QUOTE]

nwlife4 · 08-03-2009, 02:23 PM

I'm sorry it took me so long to get back to you, if you haven't found a way to finance please look up the care credit. I wouldn't say its the lowest finance you could get - i do have a great credit score but I wanted it fast and it was the fastest route- I knew i would be able to pay it off in a year. Don't let lack of credit detour you from trying though. If you call them they will answer your questions about how much your monthly payment will be and so forth. It took me matters of minutes to be approved. Airfare is not included. I live in Michigan about 4 hours away from detroit. Did I loose fast? ok I'm in constant loss of weight but in the beginning it was a struggle because I didn't have the restriction so its not like you wake up and pounds just drop off. When I finally got restriction.......wow they fell off. Now my body is totally different therefore my mind is different (I feel so much better about myself) and I do sooooo many different activities (exercise does not mean u have to b at a gym it can be riding bikes, play ball ect.) but I want to do those things. I started out at 264 and I am now 182 (and still losing its been a year 2mo.) I'm 5'5" tall and am not a skinny minnie but I feel great about the skin I'm in now. I can go into a store and try 10 outfits on and they all fit-now its trying to decide what one to buy instead of just hoping one will fit right! If there is one point of advice I can give you is please get your fill every 6weeks until you reach your sweet spot. I didn't and I could've been further along a lot quicker. We are what some may call LAP-BAND® orphans I've learned throughout the journey and a lot of my info comes from this site. I've fought my whole life with my weight losing many times each time gaining more than when I'd started. I would keep it off for 2-3 years then balloon up. You are so young I believe you would be so happy! I wish I had done it sooner. I researched it for 2 years b4 I made the commitment. Same reasons as you the finance. My husband and I stayed at the " hospital motel" I want to say it costs something like $14 or $17 under 20 anyway. I wish you the very best in this journey!!!!