Worried I will never get the band.

ladyblue9902 · 01-23-2008, 10:39 PM

I was told I have to do the 6 mo Dr supervised weight loss plan. I am just @ 40 BMI. (40.01) I actually had to gain 10 lbs to get there. Now I am worried I will put out all this money on Dr bills and just be denied because if I lose even 10 lbs I will not qualify . The surgeon I went to see said they do not submit anything to insurance until after I do the 6 mo diet because they said I would just be denied and have to appeal, but they will have to go w/ the weight I am after the 6 mo is up. I have HUMANA Insurance. I did not have any idea they covered weight loss surgery when I took out the plan . My past insurance company did not for any reason. So I had pretty much given up on the thought of ever having the Lap band. I was just trying to find a good insurance company that had co pays and was not sky high as I am self employed & it is very hard to find good affordable health care coverage. So I was very excited when I got my new insurance & the book said weight loss surgery was covered if U were clinically obese. The catch is that when I spoke w/ the insurance agent that set me up w/ Humana he asked me my weight height etc.. I told him I was 220 lbs & 5'7" which @ the time I was... (I had lost 25lbs over summer):). Anyhow he was a independent salesman and before he put me on the phone w/ the Humana Rep he said "Oh by the way I put U on a SLIM FAST diet lol so if they ask ur weight U are now 200 lbs". I was like well OK... I figured if he works for them and is telling me to fib about my weight it must not be a big deal so I did :(. Keep in mind @ that time I was not even thinking my weight would really ever matter to them. As I do not have any real problems from my weight except aches & pains & slightly elevated blood pressure & I knew I would most likely not be w/ this insurance company for ever. So my BIG WORRIE is now that I have gained 30 lbs but it looks like 50 lbs to as far as Humana is concerned. Are they going to say u lied about ur weight so we are not only going to not approve u but were going to terminate ur policy. I feel like I'm in limbo I just don't know what to expect?? Any thoughts or advice on this is would be truly appreciated. Sorry this was so long. This is my first post & I guess I poured all my questions, problems etc... in to it LOL

Chris61 · 01-31-2008, 11:26 PM

You will do just fine. The reason why they do the 6months is to see if you can do weight loss. I have a letter that you can use to help make the case for you. I would go and get all the weights from all your doctors including OBGYN and have them send the letters to the Lap Band doctor and then he can send them in. My wife had a problem with one doctor and we used here OBGYN and got here approved that way. If you e-mail me your address I will forward it to you. Also by the time you get everything together it will be six months. It took me 6 months to get it all together before I went to the doctor and then was approved within 60 days of seeing him. The rest is history.

Chris