Have lap-band insurance now; almost wish I didn't

[Littleroo27]

I've spent the better part of the past 9 months going through the process. Went to Scripps Weight Loss Center. Did all the pre-op requirements. Got my form saying I'm sane and talked to the dietician. Then I find out that my insurance won't cover the surgery no matter what.

So I find Dr. Ortiz. I research until I can't find anything I haven't already learned and then I go down to TJ and tour the clinic and speak with Dr. Ortiz. I'm completely comfortable with this choice and know that he's one of the best.

Then, a week or two ago, I found out that we are switching to Cigna and that their HMO covers the Lap-Band. Joyous singing is heard throughout the land!

Yesterday I went to the insurance change meeting and found the list of bariatric surgeons covered under the HMO plan.

I researched every one of them within 80 miles (9 in total). The most experienced surgeon has done 100 lap-band procedures. One of them brags on his website about his 4% complication rate (with the US average being around 12-14%). I'm just thinking that Dr. Ortiz's rate is less then 1% and now I wish I didn't have insurance!

I can't actually afford to spend $10,000 and the relief of having to come up with 10% instead was wonderful. But now I'm scared and frustrated because most of the surgeons covered still only perform Gastric Bypass or Reux-en-Y.

My choices are:

George Mueller, MD, who has performed 2 lap-band surgeries as of September

Milton Owens, MD, who has performed approximately 100 and is my best option at this point

Kyle B. Potts, MD, whose office is just beginning to offer the lap-band procedure

Not exactly jumping for joy at my options

The surgeons I was working with before Dr. Ortiz aren't covered under Cigna. Their counterparts at Scripps Mercy are, but they only do the Roux-en-Y.

GRRRR. I think it's super mean that the insurance will cover the procedure but not a qualified doctor to do it.

I e-mailed them today and whined, but am feeling really frustrated and choking in red tape.

[cyndiwilson]

I've spent the better part of the past 9 months going through the process. Went to Scripps Weight Loss Center. Did all the pre-op requirements. Got my form saying I'm sane and talked to the dietician. Then I find out that my insurance won't cover the surgery no matter what.

So I find Dr. Ortiz. I research until I can't find anything I haven't already learned and then I go down to TJ and tour the clinic and speak with Dr. Ortiz. I'm completely comfortable with this choice and know that he's one of the best.

Then, a week or two ago, I found out that we are switching to Cigna and that their HMO covers the Lap-Band. Joyous singing is heard throughout the land!

Yesterday I went to the insurance change meeting and found the list of bariatric surgeons covered under the HMO plan.

I researched every one of them within 80 miles (9 in total). The most experienced surgeon has done 100 lap-band procedures. One of them brags on his website about his 4% complication rate (with the US average being around 12-14%). I'm just thinking that Dr. Ortiz's rate is less then 1% and now I wish I didn't have insurance!

I can't actually afford to spend $10,000 and the relief of having to come up with 10% instead was wonderful. But now I'm scared and frustrated because most of the surgeons covered still only perform Gastric Bypass or Reux-en-Y.

My choices are:

George Mueller, MD, who has performed 2 lap-band surgeries as of September

Milton Owens, MD, who has performed approximately 100 and is my best option at this point

Kyle B. Potts, MD, whose office is just beginning to offer the lap-band procedure

Not exactly jumping for joy at my options

The surgeons I was working with before Dr. Ortiz aren't covered under Cigna. Their counterparts at Scripps Mercy are, but they only do the Roux-en-Y.

GRRRR. I think it's super mean that the insurance will cover the procedure but not a qualified doctor to do it.

I e-mailed them today and whined, but am feeling really frustrated and choking in red tape.

I've spent the better part of the past 9 months going through the process. Went to Scripps Weight Loss Center. Did all the pre-op requirements. Got my form saying I'm sane and talked to the dietician. Then I find out that my insurance won't cover the surgery no matter what.

So I find Dr. Ortiz. I research until I can't find anything I haven't already learned and then I go down to TJ and tour the clinic and speak with Dr. Ortiz. I'm completely comfortable with this choice and know that he's one of the best.

Then, a week or two ago, I found out that we are switching to Cigna and that their HMO covers the Lap-Band. Joyous singing is heard throughout the land!

Yesterday I went to the insurance change meeting and found the list of bariatric surgeons covered under the HMO plan.

I researched every one of them within 80 miles (9 in total). The most experienced surgeon has done 100 lap-band procedures. One of them brags on his website about his 4% complication rate (with the US average being around 12-14%). I'm just thinking that Dr. Ortiz's rate is less then 1% and now I wish I didn't have insurance!

I can't actually afford to spend $10,000 and the relief of having to come up with 10% instead was wonderful. But now I'm scared and frustrated because most of the surgeons covered still only perform Gastric Bypass or Reux-en-Y.

My choices are:

George Mueller, MD, who has performed 2 lap-band surgeries as of September

Milton Owens, MD, who has performed approximately 100 and is my best option at this point

Kyle B. Potts, MD, whose office is just beginning to offer the lap-band procedure

Not exactly jumping for joy at my options

The surgeons I was working with before Dr. Ortiz aren't covered under Cigna. Their counterparts at Scripps Mercy are, but they only do the Roux-en-Y.

GRRRR. I think it's super mean that the insurance will cover the procedure but not a qualified doctor to do it.

I e-mailed them today and whined, but am feeling really frustrated and choking in red tape.

Hey ROO - I am sorry to hear of your luck? we all like ot have insurance but sometimes when it comes to these procedures it's more apain in the a$$ - have you thought about maybe contacting Lori Becky to see if she can check with Dr. Ortiz to seeif possibly he may have trained or knows of these MD's? Just a thought

[Littleroo27]

Hey ROO - I am sorry to hear of your luck? we all like ot have insurance but sometimes when it comes to these procedures it's more apain in the a$$ - have you thought about maybe contacting Lori Becky to see if she can check with Dr. Ortiz to seeif possibly he may have trained or knows of these MD's? Just a thought

I have thought about that and very well may. Right now I'm trying to work with my insurance company and see if I can get them to add more lap-band qualified surgeons, but I know that will be like pulling teeth!