Insurance starts today, my LAP-BAND® journey starts tomorrow

Hey guys, i have been a reader of all the threads for months, probably since october. I finally decided to write my first one.
I had been a temp since September 4th and finally got hired on at my job on Feb. 17th. My insurance starts today, I will be calling tomorrow to choose my pcp and schedule an appointment. My company offers 5 health plans, 3 bcbs, 1 kaiser, and 1 pacificare. The only one that covers the surgery is pacificare so i chose my insurance just on the fact that they cover the surgery. I also am choosing my pcp solely on the fact that its in network of the surgeon i have decided on. So literally everything has been based around the surgery. and of coarse pacificare was the most expensive option so between health, dental, vision i pay $230 out of EVERY paycheck, and I get two paychecks a month!

isnt that crazy?
anyway, im a mother, wife, and hard worker! I have attempted losing weight all my teenage years and now into my 20's. I have ALWAYS been overweight. I know what to do, and I am a very determined person. I am on weight watchers for the 3rd serious time. 2 times before I lost 30 pounds and for some reason I can never get past that point. since Jan 7th this year I have lost 15 pounds and hopefully i will never have to get back to where I was. Im hoping to continue with WW until the surgery, and then still keep going on WW! I seriously think I will be doing WW forever, i love the things they teach you and how much it helps you understand whats going into your body.

So I dont know how I should set this up, probably a blog, I just want a complete record of everything I have done with this journey.

I will write back once I have the referral from my doctor to go see Dr. Leport in Fountain Valley!!

Congratulations with your decision! For me, it's the best one I ever made. I'm 27 lbs down -- which is more than I've ever been able to lose on WW -- and I'm still feeling very motivated and am not at all tired of this "diet"/lifestyle change.

On the blog front, I started one just before surgery (link below) and I'm glad that I did. It's been great to have a record of my progress, how I've been feeling, and even just basic events during the past several months.

One thing I will recommend is that you get out the measuring tape today and take your measurements (waist, hips, upper arm, forearm, wrist, thigh, calf, ankle, chest). I've found it really interesting to see how many inches I've lost so far and where the weight is coming from. Plus, it's a great measure for when you're working out a lot and the scale may not be moving, even though your body is getting better & better.

All the best,

Catherine

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230/165.2/155
Banded 10/23/08
Blog: http://chroniclesfrombandland.blogspot.com

Wow .. 5 plans to choose from.

I am curious, what 3 bcbs plans did you have to choose from.

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Seminar - 11/08/08 Init Visit - 11/19/08 BMI - 41.
Stress Test - 11/24 Psych Eval - 12/02 Nutrit 01/08
Approval - 01/14/09 Surgery - 02/06/09
1st fill 02/19 - 4 ccs 2nd fill 04/02 - 3ccs
lost 101 lbs - 18 inches in 6 months - Reached Goal Wgt

Thread Starter

To tell you the truth im not sure what the 3 plans were that were offered. As soon as I got word that I was getting hired on i asked our benefits cordinator which insurance plans covered LAP-BAND®, she said only the pacificare plan covered that.

So guys, I called yesterday and made my first appointment with my new Dr. THe receptionist asked what the purpose of the visit was and I told her that I wanted the Dr. to give me a referral for LAP-BAND® to Dr. Leport. She was like OK thats awesome we will see you then!!!

I leave for a cruise on 3/19, and my Dr. appointment is for 3/16, so Im hoping by the day I set sail I will have the approval and I can make my appointment with Dr. Leport for when I get back, maybe, just maybe!!! lol

WW meeting tomorrow, we shall see how much I have lost since last week.

Thread Starter

wanted to let you guys see my stats....

Insurance started 3/1
First appointment with PCP to get referral 3/16

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3/17 Lab work done 3/22/2009 got approval to see Dr. Leport! 4/3/09 1st class at surgeons office 4/9 Support group 4/17 psych evaluation 4/23 nutrition class 4/27 Dr. talk, 4/29 submitted to ins. 5/1 approved!!!!!!!!!!Surgery July 8th! whoohooo

check out my weekly episodes at
http://www.youtube.com/laurentayler87

laurentayler,

I am in Garden Grove not too far from you and will be getting banded on the 13th. I also have UHC/PacifiCare but I have a PPO. I did not have to get a referral from my PCP. As far as PacifiCare I have been told by my doc that this is one of the easiest carriers to get approval from here in Ca. I would like to keep in touch as we live so close to each other.

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Banded 03/13/09

Thread Starter

Good luck thats awesome!!!!
Keep in touch!

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3/17 Lab work done 3/22/2009 got approval to see Dr. Leport! 4/3/09 1st class at surgeons office 4/9 Support group 4/17 psych evaluation 4/23 nutrition class 4/27 Dr. talk, 4/29 submitted to ins. 5/1 approved!!!!!!!!!!Surgery July 8th! whoohooo

check out my weekly episodes at
http://www.youtube.com/laurentayler87

Thread Starter

I called today, im officially in the computers at Pacificare! the girl told me something not very nice! lol

she said that in the end it is solely up to the medical group whether im approved or not. She didnt think that LAP-BAND® was covered but she knew that bypass was! I almost slapped that girl across the phone line. I was like no I chose this insurance only because I was told that you cover LAP-BAND®.

she said that basically their job is done and they have nothing left of it. THey pay the medical group to manage my case so they dont have to deal with it.

so if ADOC Fountain Valley decides to cover it, then im covered!

Anyone else have ADOC-FV?

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3/17 Lab work done 3/22/2009 got approval to see Dr. Leport! 4/3/09 1st class at surgeons office 4/9 Support group 4/17 psych evaluation 4/23 nutrition class 4/27 Dr. talk, 4/29 submitted to ins. 5/1 approved!!!!!!!!!!Surgery July 8th! whoohooo

check out my weekly episodes at
http://www.youtube.com/laurentayler87

Hi There! Besides the part about being a mother, I do not have kids, it sounds like we have and are living the same life lol. I'd love to walk you through everything if you need any help. We are the same age too and I love meeting people my own age. You should take a look at my profile...I have kept a pretty detailed timeline of my journey from the day I went to my seminar. Please don't hesitate to ask if you have any questions! Welcome!

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Breannewww.ladylapband.com

Turkey Day Challenge / New Year, New You Challenge

Thread Starter

awesome news!!!!

so im already guessing this will be a long one, but oh well haha.

So i went to see my Primary for the first time today. I started to tell him i wanted LAP-BAND®, and i told him why, and that I started WW on Jan 7th and Ive lost 18 pounds. of coarse he asked all the general questions, and talked about my family. Then after him having no emotion at all when speaking about him, i finally asked, "what do you think of the surgery?" all of a sudden he was all excited. He told me how much he loved it, and the results are great, and he thinks it would be awesome for me to do. I told him that I wanted Dr. Leport and he started to say that oh hes the best..... and I interupted him and said yea in the area right? he looked at me all serious and says, No, west of the mississippi. lol He said people travel from all over the world to see Dr. Leport. It made me feel soooo good. In the end he told me that my medical network typically requires a 6 month diet, but since I started WW in January and that is documented I can count that as the time i started so I have almost 3 months done now. He told me to go get my labs done and they will set up the referral. once he has my lab work back and makes sure I dont have any issues like thyroid or something, then he will submit it ASAP.

Hopefully within the next couple weeks I get an answer saying what i need to do before I go see the surgeon.
Im hoping i can get all the requirements done before seeing the Surgeon, so once I see him I can just schedule it then.
It will be a long process, but I need to earn up my vacation time for the surgery, and I want to lose a good amount of weight by the time I have the surgery.

Im sooooo excited because I got a good response, he could have said no you are too young, or no i dont support LAP-BAND®, just keep going on WW or something like that. But he loves it! and he loves Dr. Leport!!!! yay!

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3/17 Lab work done 3/22/2009 got approval to see Dr. Leport! 4/3/09 1st class at surgeons office 4/9 Support group 4/17 psych evaluation 4/23 nutrition class 4/27 Dr. talk, 4/29 submitted to ins. 5/1 approved!!!!!!!!!!Surgery July 8th! whoohooo

check out my weekly episodes at
http://www.youtube.com/laurentayler87

Thread Starter

I did my lab work today. then called the Dr. office and they said they had already put the request in. THe lab work will be one of the things on the list of things I have to do prior to seeing the surgeon. So I leave on thursday for my cruise, hopefully being gone will help keep my mind off of it and maybe sometime next week I will get word of all the things I gotta do before i get the referral!!!

one step closer yay!

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3/17 Lab work done 3/22/2009 got approval to see Dr. Leport! 4/3/09 1st class at surgeons office 4/9 Support group 4/17 psych evaluation 4/23 nutrition class 4/27 Dr. talk, 4/29 submitted to ins. 5/1 approved!!!!!!!!!!Surgery July 8th! whoohooo

check out my weekly episodes at
http://www.youtube.com/laurentayler87