Hello...

Hello!  I am been lurking for a week and decided I should finally post.  I wanted to thank everyone else for their inspiring posts and information.

I looked into lapband 3 years ago because it was minimumly invasive and the reports looked great(so I thought) I was just finishing the required 6 months prep appointments when I lost my job and gained 40 more lbs.  I now have insurance again and went back to my bariatric center.  Again I was interested in the band.  They went over the 4 surgeries that they do, and thought the band would not be for me because of my high BMI of 62.  They said they wouldn't try and talk me into a bigger surgery, but that I needed to go home and do more research.  OMG!  I am so thankful for this site, there is no way that I would ever get banded now!  I am so thankful that I didnt get it.

I am hoping to get the Sleeve.  I called my insurance and they do cover it with a lifetime cap of $10,000.  Has anyone else ever heard of this and do you think it may be possible to appeal?

Donna

Welcome to the site.  I did a lot of lurking as well pre-op.  I am now one year post-op.  While it has indeed been a rollercoaster ride, a love-hate relationship, I don't regret the procedure most days.  I'm now actually below my original weight goal and wish you much, much success on your journey.  

Unfortunately, I can't address your insurance question, as I was 100% self-pay -- bummer!  The $18,000+ procedure would perhaps be viewed by some as a selfish gesture, but I instead chose to view it as a life investment.

Don't get discouraged.  Jump through the hoops and make it happen!

I completely agree with "bigtime" I am also self pay, and I think it's one of the very best invesments I will make.  I mean if you can appeal it great, if not whatever you have to cough up to make it happen will be worth it in the long run. 

Thank you both for your replies.  I also agree that it will be an investment in my health.  In August of 1998 I went on a liquid diet for 4 months straight and lost 100 lbs. and through the next eight months lost an additional 60 lbs.  I had started at 300 and got to 160 for a second and settled at 175 which was a size 10 and a medium top which I thought was great but not good enough for the doctor because I am 5' 4" and my BMI was still too high.  I kept it off for 2 1/2 years and then it started piling back on as fast as it left plus 60 other friends.

I understand that the Sleeve is a tool and I am the one that needs to make it work.

Hi welcome! the limit will probably not be appeal able but you can work with your surgeon...they lower cost to watch insurance companies are willing to pay all the time...and anything you have to pay out of pocket is soooooo worth it!!! I ended up paying 2500 after insurance and think it was worth every penny!! also we have saved nearly that much on food in the last nine months as we were eating out twice a day before and now we all stay home cuz its not worth it for me to spend the money most of the time! good luck in your journey!

I had some good news today.  The coordinator from my bariatric center called to say she had talked with my insurance and that the $10,000 lifetime cap is just toward the surgery and the preop tests and visits are covered.  The last time I spoke with someone they said it was all lumped in together under that $10,000.  I have my labs, and other tests on Monday and then meet with the Dr. the 18th of July.  I am required to loose 18 lbs. prior and I have lost 12 in the last 13 days, so really hoping to be able to get submitted soon so I possibly could have an early August date when I would be able to have coverage at work.