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FOR THOSE THINKING OF LAP BAND


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  • 2 weeks later...

Is there anyone on here whose insurance has paid for the lap-band surgery, and what were the circumstances/conditions in which the insurance agreed to pay? For example, did they just agree to pay for the lap band surgery, or were you having another surgery, ie., gall bladder, and the Dr. just went ahead and did the lap-band while they were in there. My general physician said that I qualified for the surgery, but I want to know if the insurance will pay for it or not. I live in a very small rural community and the nearest city where this surgery would be performed is over 2 hours away. I will have to take off work to go to an initial consultation. I'd prefer not to waste a sick or vacation day to drive a 4 hour round trip and sit in a doctors office for the other 1/2 day just to find out that I'd have to take out a HUGE loan. Anybody have any info or advice? Thank you!

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Is there anyone on here whose insurance has paid for the lap-band surgery, and what were the circumstances/conditions in which the insurance agreed to pay? For example, did they just agree to pay for the lap band surgery, or were you having another surgery, ie., gall bladder, and the Dr. just went ahead and did the lap-band while they were in there. My general physician said that I qualified for the surgery, but I want to know if the insurance will pay for it or not. I live in a very small rural community and the nearest city where this surgery would be performed is over 2 hours away. I will have to take off work to go to an initial consultation. I'd prefer not to waste a sick or vacation day to drive a 4 hour round trip and sit in a doctors office for the other 1/2 day just to find out that I'd have to take out a HUGE loan. Anybody have any info or advice? Thank you!

Spend some time on the phone with your insurance company. Some companies won't even cover them...mine included, which is why I selected Dr. Ortiz for my banding. I'm very rural myself...spent my day off on Friday making an 8 hour round trip to get a fill. It's just one of those things I'm used to having to do in order to live in a beautiful area of the country.

Twigs

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Is there anyone on here whose insurance has paid for the lap-band surgery, and what were the circumstances/conditions in which the insurance agreed to pay? For example, did they just agree to pay for the lap band surgery, or were you having another surgery, ie., gall bladder, and the Dr. just went ahead and did the lap-band while they were in there. My general physician said that I qualified for the surgery, but I want to know if the insurance will pay for it or not. I live in a very small rural community and the nearest city where this surgery would be performed is over 2 hours away. I will have to take off work to go to an initial consultation. I'd prefer not to waste a sick or vacation day to drive a 4 hour round trip and sit in a doctors office for the other 1/2 day just to find out that I'd have to take out a HUGE loan. Anybody have any info or advice? Thank you!

My insurance paid for it. Have United Healthcare, and the conditions were:

- BMI over 35, or obesity related disease (high blood pressure, diabetes, etc.) Mine was 43, with no related diseases.

- 5 year history of obesity (I had doctor records showing weight over the last 5 years.)

- 5 year diet history (you have to show you've tried. I had weight watcher paperwork from years back.)

- Primary doctor's letter of recommendation

- Chest x-rays and a complete physical.

Once I had all these things, my doctor's office who did the surgery sent all of that in to my insurance. It took 2 weeks and I called every day. I was told by someone that if you call, they're more likely to accept it. They did! I couldn't afford it otherwise.

It's been a week now since my surgery and all I've paid is my co-pay.

As far as time off, I had vacation time that I was going to take, but my boss suggested I look into our company's short-term disability policy. Turned out surgery was covered, and I can get time off without having to take vacation time.

Another note on the insurance. I called and asked what I needed to have the lapband covered and was told a certain BMI, and a doctor's note. My doctor's office said no...that the insurance company will do that, but then deny it and need more information. So, I gathered all the stuff ahead of time. Basically more information is better. :)

Hope all this helps!

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