Apologize for being redundant, but Noob with question

inzane · 05-23-2008, 01:20 PM

I live in Pennsylvania, I have Highmark PPO Blue. Over a year ago, I was approved for gastric bypass surgery with a BMI at 41%. I went to the first consultation but decided I didn't want to have that radical of surgery. I am, however, very very interested in the Lap Band since it is not nearly as invasive. I think I was told at my initial consultation that lapbanding was not currently paid for by insurance companies in PA. Does anyone know if Highmark PPO Blue has changed their tune? I would ask my doctor, but he passed away and I haven't discussed gastric banding with my new doctor.

blueriley · 05-23-2008, 01:35 PM

I would just call your insurance provider and ask them if the banding is covered and if it is, what are the requirement (i.e bmi, comorbidities). Thats what I did and my insurance co rep gave me all the info.

Kate Eryn · 05-23-2008, 02:05 PM

Quote:

I think I was told at my initial consultation that lapbanding was not currently paid for by insurance companies in PA. D

That's definitely not correct.... :)

When I was banded in 2004 I had BCBS, they do indeed cover it. My friend Lexy just got banded on Monday and has United Healthcare and they covered it.

Brace yourself. Insurance companies lie. Keep at it!

ConcettaHughes · 05-23-2008, 02:36 PM

i live in PA. I had my surgery done at the University of Pennsylvania in Philadelphia, PA by Dr. Noel Williams. When I had my first consultation with his unit, all I had to do was give his nurse my insurance information and she took care of everything. They know how to word things so that the insurance does not turn you down! It is a fabulous program there and if you are not too far away, I recommend using them highly! I was banded on 1/31/08 and have lost 50 pounds to date. I am very happy with the results. Like I said, the program with them includes a nutritionist to help you relearn how to eat properly and healthy. Call them, I'm sure they will try to help you!