LMJLMJ Posted May 14, 2007 Report Share Posted May 14, 2007 Hi, my name is Michelle and this is my first post here. My BMI is 36.5 and my insurance (BCBS of CA) covers Lapband w/ a BMI over 35 w/ comorbidities. I have several "little" things but nothing HUGE. I have a past history of gestational diabetes. I have had blood sugars out of normal range within the last several months and I will be going for labwork Wed to hopefully have a diagnosis of prediabetes or insulin resistance or SOMETHING, I hope I also have hypertension off and on and I honestly have several problems that I have never gone to the Dr for such as chronic back/feet/hip pain, heartburn (reflux), stress incontinence, and abnormal periods. I also have a history of infertility. My parents are both overweight, and there is a history of diabetes on my dads side, history of cervical/uterine cancer on my moms side. So, my problem is, Im afraid all of this will not be enough to be approved by my insurance. Does anyone have advice on this or what I can do or be tested for to increase my chances of approval? Thanks! Link to comment Share on other sites More sharing options...
oktwigs Posted May 14, 2007 Report Share Posted May 14, 2007 Hi, my name is Michelle and this is my first post here. My BMI is 36.5 and my insurance (BCBS of CA) covers Lapband w/ a BMI over 35 w/ comorbidities. I have several "little" things but nothing HUGE. I have a past history of gestational diabetes. I have had blood sugars out of normal range within the last several months and I will be going for labwork Wed to hopefully have a diagnosis of prediabetes or insulin resistance or SOMETHING, I hope I also have hypertension off and on and I honestly have several problems that I have never gone to the Dr for such as chronic back/feet/hip pain, heartburn (reflux), stress incontinence, and abnormal periods. I also have a history of infertility. My parents are both overweight, and there is a history of diabetes on my dads side, history of cervical/uterine cancer on my moms side. So, my problem is, Im afraid all of this will not be enough to be approved by my insurance. Does anyone have advice on this or what I can do or be tested for to increase my chances of approval? Thanks! Most of the people who post here are patients of Dr. Ortiz who are self-pay for a variety of reasons (insurance, lower BMI, etc.). So I doubt many of us could help you with the insurance issues. You might find more help on either http://band2gether.net/ or www.lapbandtalk.com. Don't get me wrong, you are more than welcome to join in our discussions, but we probably won't be much assistance and I don't want you to think we are snobby. I chose Dr. Ortiz because of his excellent record of success and his wonderful staff. Since I was self-pay, going to Mexico was my only option and I felt lucky to find Dr. Ortiz. Twigs Link to comment Share on other sites More sharing options...
LMJLMJ Posted May 14, 2007 Author Report Share Posted May 14, 2007 Oh, Im sorry. I didnt realize that.... Link to comment Share on other sites More sharing options...
KatieB Posted May 15, 2007 Report Share Posted May 15, 2007 Oh, Im sorry. I didnt realize that.... LMJ, I too am a lower BMI with No comorbidities. My insurance told me that I would have to have been treated by my primary doctor for the past 5 years with no results and some comorbidities would have to be documented. Well, needless to say, I just didnt want to wait for 5 years to get my battle with the bulge documented and hopefully have some terrible disease or illness within that time, so I opted for self pay in MX. I looked into having it done in the states and then I found out how much experience the surgeons had, practically none, especially when I compared them to Dr. Ortiz. And then the cost, WOW, they US surgeons wanted to charge twice the amount to do the same surgery that they had minimal experience doing, I was definately not doing that. You should call your insurance co and they will tell you the procedure to follow if you want them to pay for the surgery, and they will tell you what is and what is not covered and if you would even qualify. Just do your homework, you'll get there. Good luck on your journey. Link to comment Share on other sites More sharing options...
QueenOfChunk Posted May 15, 2007 Report Share Posted May 15, 2007 I was self pay...insurance didn't cover. SO I didn't have to have any issues. I can tell you however, that a few years back my friends mother got banded and had a low bmi. She told them she couldn't sleep and they accepted her. Link to comment Share on other sites More sharing options...
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