Has anyone NOT been 100lbs for 5 years and still had the lapband done.. or at least no...

I have not even had doctor for 5 years LOL  But I have had the same OB/GYN so would my once a year visit weigh in with them be good enough to prove the 5 year thing?  My insurance has emailed me in writing that you do not have to be over weight for 5 years before getting approved for surgery, but what I see on here most doctors have that rule to qualify right? And how did you pick your doctor?  Did you start with a seminar or schedule a consultation?  I just don't know where to start exactly.  I see my doctor (PCP that I have had for 3 years) on wednesday and plan to talk to her about it and see what she says too.  But I am ready to get this ball rolling!

Yes your weigh in at your OB/GYN can count as that. I used multiple things to show at least 5 years of obesity (because that was required at that time by my insurance and surgeon) including any type of doctor, ER visit, ANYTHING that weighed me and wrote it down. I picked my doctor by scoping out the web (goggled Indiana LapBand surgeons, Bariatric LapBand Indiana, etc...) and first found a facility (I chose St Francis's) and then picked a surgeon from their roster(sp?). I then contacted St Francis's to get inquire material. Called my insurance company. Made an appointment with my PCP and told him. Conctacted St Francis's again to let them know that I had my PCP and insurance in progress and let the three of them sort it out while I sat at home waiting for notifications for appointments and such. Good Luck Jodi

Thanks for your help! Another question for you, did they require you to do the 6 month diet?

The 6 month "diet" (usually called a medically supervised weight loss program by the insurers) is actually an insurance requirement, not a physician/surgeon requirement and every insurance I have ever heard of required 6 consecutive months of monthly (sometime twice monthly) visits for a medically supervised weight loss program. Good luck!

Yep but it didn't have to be consecutive.

When I talked to my insurance company (more then once LOL) they said they do not require a 6 month "medically supervised diet" It is also not listed on the "requirements"  sheet they sent me either.  So maybe they won't require it since it isn't on the list?  They just make it sound so easy to get approved.. I am sure that will play out differently LOL But considering I haven't even MADE THE CALL yet to set up a meeting or consult.. it could be awhile.  I just can't get myself to pick up the phone and schedule it! 

I was only able to come up with 3 years of doctors records but I had a bunch of comorbidities tooo. I knew I was going to St Vincents and after my doc referred me they called me to set up my consultation. They asked what procedure I wanted and if I had a surgeon preference. I said I wanted the RNY and didn't have a preference and I got Dr. Cacucci! I'm so glad I did. She is just awesome. I didn't have to have any dr supervised visits or anything but I had seen dietitians and stuff in the past.

Dr. Gupta's team did let me know that 95% of Insurance companies do require a 6 month diet now.  You insurance may be in the 5% range.  The first thing you have to do to get the ball rolling is basically choose what netowrk you want to have the surgery (ie St. Francis, St. Vincent, Clarian) or just pick a surgeon that is right for you.  After that you then need to call and set up a consultation.  That is the main aspect to get the ball rolling.  They will ask for insurance info and whatnot, and also ask you what date basically suites you better or you can ask for a specific surgeon and they will tell you what days they have consults and they will get you in one of them.  As far as the five year thing goes, Dr. Gupta and her staff is currently working on that.  Since I am under 21 Anthem has to have the consent of Two Surgeons that this surgery is medically neccessary for me, and Dr. Gupta beleives that, that shouldn't be a problem since my BMI is so high.  Other than that, I havn't had sugery yet, I am still actaully in my first month of supervised dieting.  So I hopefully will be approved by october at the lastest if all goes as planned.  GOOD LUCK!

Well I called and schedule a consult with Dr. Gupta!  Then I saw your message, that is funny!  I also schedule the psychological eval too.  I am excited and nervous as I haven't told anyone but my husband.  My husband is supportive, but not so sure the rest of my family will be.  I know it is sad but I probably won't even tell them until I have a date set for surgery LOL  I just don't want to hear them try and talk me out of it. So we will see how it all pans out.  Hopefully it will be as easy as the insurance company makes it out to be!

Good luck Leanne.  Dr. Gupta is awesome!!!! and sherri can go in some major detail with that fact!..lol!  I do hope that everything goes well, and you will have a quick and easy journey!  When is your consult date?