Nervous about my insurance approval!
So I've started going through the initial stages for lap band surgery but I am so nervous my insurance company will deny me. My BMI was 40.1 (I’m about 120 lbs over my ideal weight for my height), suffer from ankle pain, and I have high blood pressure that causes really bad migraines. The dietician, psychologist and physician all three said I'd be a good candidate and that I'll require little behavioral modification since I'm constantly on a strict eating habit and I'm relatively active.
My paperwork is being submitted as soon as they receive the write up from the psychologist (should be before December 18th). BUT ... I am so nervous my insurance company will deny me for some stupid reason. My insurance is Blue Cross Blue Shield of Illinois, their requirement is :
- You are 100 pounds or more above ideal weight, or
- You have a Body Mass Index above 40, or
- You have a Body mass Index of 35 or greater and suffer from medical problems associated with obesity such as coronary heart disease, type 2 diabetes, sleep apnea or hypertension.
- You have been overweight for at least five years, and
- You have failed all weight-loss attempts including diets, exercise and weight loss programs.
Anyone else deal with Blue Cross Blue Shield of Illinois? Good/bad experiences?
The very last bullet point has me extremely nervous. Every doctor (both Family Dr. and my OB GYN) visit we spoke about what I was doing to lose weight but I don't know if thats enough. The clinic seemed confident I met all the requirements but I am not coping well with the fear that I could get denied :(
Please reconsider your choice of surgery - your insurance company may even deny BECAUSE you chose lap band surgery - it really is the worst of all worlds in terms of complications and longevity of the band - most have to be removed after a while with THAT surgery NOT being covered!!!! You will need to be prepared to fund this as many insurance companies have a once per lifetime clause now.
Do some research on VSG (sleeve) which will give you the restriction you want without the problems of malabsorption.
Proud Feminist, Atheist, LGBT friend, and Democratic Socialist
A few reasons I chose the lap band were...
1. If there are no complications, you aren't required to stay at the hospital overnight. This is nice for me because I really don't do well in a hospital setting.
2. It can be reversed for what ever reason. I understand that if you get it removed that most likely you'll gain your most of your weight back but I like the option of having that choice.
3. The recovery time is about half the others which again is nice. I won't have to miss much work.
4. Its a slow and steady weight loss so my body and mind won't be shocked by rapid weight loss and I can hopefully work out enough to avoid any real access skin issues. I imagine I'll have some but losing the average 3-4 pounds a week seems safer than the rapid weight loss of the other two options and long term they all sort of level out.
5. It still requires you to work to lose weight. I didn't want an option that did it for me. I wanted a tool that will help me along the weigh where all other options have failed.
Which are you consindering?
A few reasons I chose the lap band were...
1. If there are no complications, you aren't required to stay at the hospital overnight. This is nice for me because I really don't do well in a hospital setting.
2. It can be reversed for what ever reason. I understand that if you get it removed that most likely you'll gain your most of your weight back but I like the option of having that choice.
3. The recovery time is about half the others which again is nice. I won't have to miss much work.
4. Its a slow and steady weight loss so my body and mind won't be shocked by rapid weight loss and I can hopefully work out enough to avoid any real access skin issues. I imagine I'll have some but losing the average 3-4 pounds a week seems safer than the rapid weight loss of the other two options and long term they all sort of level out.
5. It still requires you to work to lose weight. I didn't want an option that did it for me. I wanted a tool that will help me along the weigh where all other options have failed.
Which are you consindering?
Most likely going to go with the sleeve....just to many problems with the band from what I heard. Go with whatever is best for you but do as much research as you can. BEST OF LUCK!!!!
Please do not feel bad that so many are against the lap band. We have all researched all of the procedures. I'm sure you have as well. Almost everything I've read and heard shows at least a 50% failure rate for lap band surgery with minimal average weight loss.
You don't know me, and don't have any reason to care about my opinion about what type of surgery you choose. Even as I type this I am having an internal monologue telling myself to back off because this is absolutely none of my business. That being said if I don't say something I will wake up at 3am wondering if I maybe should have said something. So here goes...
My arguments to your reasons...
1. With VSG chances are you would only stay one night...most of the time the hospital will allow a friend or family member to stay at the hospital with you to make you more comfortable. They will usually even bring them a fairly comfortable recliner to sleep in.
2. Other than the band causing heal risks, why would you need it to be reversible? RNY is also reversible. Did you know that you can actually live a pretty much normal life with no stomach?
3. I had a VSG last Wednesday and was back to work this past Monday (5 days). I am a busy wife and mom as well and have had no problems keeping up this week. The weight lifting and movement restrictions seem to be about the same for all 4 surgeries.
4. You are correct that the weight does come off slower, but I'm sorry 100lbs is 100lbs. You are going to have excess skin. I have seen several youtube videos of people that had the lap band showing just as much excess skin as the other surgeries. You are either going to have excess skin or your not. The long term effect of losing weight rapidly does not seem to hinder the ability to maintain a healthy weight nor does it seem to adversely affect the health of the patients.
5. I can tell you that even after one week out I will have to work extremely hard for my weight loss no matter which tool I have.
I'm sure your mind is made up already, but I truly hope that you read and take into consideration what folks are saying.
Good luck in whatever you choose!
http://www.bariatric-surgery-source.com.html
Thank you so much for leaving a response! I honestly didn't know you could live a normal life with no stomach. it's actually what scared me and turned me off. I really do appreciate you insight! This post has left me with more questions for my doctor so i will be asking even more questions I hadn't thought about. Thank you again :)
Batwingsman · 4 replies · 1322 views