Question:
Inusrance won't approve the lap
not sure what to do I did want the lapband bt my INC dened it so i dont know eather to fightthem or not bt the do aprove for the gastric bypass not sure if they would for lap but iam sure they wuld but what i would like to know is their any one that has had the LAP RNY an did ot have any problems with it? Please anwser here or e mail me I have got to do something an if all i can do is the lapRNY then i will do it but it just scares memore than the lapband — wildbrat (posted on August 7, 2002)
August 7, 2002
Beth I struggled with this issue myself see my profile. I finally settled
on the RNY and am glad I did. My wife needed wls too and with her extremely
high BMI my surgeon said the and wouldnt be as effective. I figured we
should both be the same but what REALLY convinced me was a bandster I spoke
with on the phone. He sid he would like a whopper but was settling for
shakes instead. :(:(:( I loved milkshakes and they are band friendly. THe
RNY with the icky feeling is much better for me. Truly dont worry, post op
is the place to be!
— bob-haller
August 7, 2002
I think your insurance won't cover it as it is a fairly new in the states.
When I first started looking into WLS I was thinking Lap-band all the way
but the stats just weren't good enough for me. Then I read about some folks
who had problems with it falling off which caused some complications. I
suppose it's true that there is no such thing as a risk free surgery! I
chose to have the laproscopic Bypass and will go in for surgery on 11/11!
I'm scared but excited to start a new life.
Good luck in your decision!
— Colleen S.
August 7, 2002
I have just had lap RNY. My insurance provider (Cigna) approved on the
first letter 2 days after receiving it.
I do have several comorbidities though that helped in their decision. I am
diabetic, have high blood pressure, high cholestrol, mild sleep apnea
(Don't need CPAP machine)and other minor problems.
You may need to have tests done prior to surgery. Have you talked to your
PCP? Have they recommended you for surgery?
It seemed that I couldn't jump enough hoops with the DRs before I was sent
to see Dr. Murayama my surgeon. Cigna would only approve if letter was from
surgeon. Good Luck
— Candice B.
August 7, 2002
Hello all,
I'm a benefits manager and have to deal with HMOs all the time. HMOs all
work a little differently but generally the HMO pays your PCP just because
he/she is listed as your PCP. In other words, even if you never see your
PCP he still receives payment from the HMO. However, if a PCP refers a
patient to a specialist they can lose money. Unfortunately, this may be the
case with your PCP.
Then again some Doctors just close their mind to WLS. Either way it should
be your choice! Find another doc!!
— Colleen S.
August 7, 2002
I had the lap RNY. The band is fairly new and a lot of insurances are not
covering it yet. My Dr had just started doing them. The reason I chose the
RNY is because I wanted the extra tool of dumping and NOT being able to eat
sweets, ice cream and all the fatty things. I had no control over these. I
have not tested to see if I would dump with them, I'm satisfied just
knowing I should dump and for the past 9 1/2 months that has been good
enough for me. The weight loss proven to date in the US has been much
better also with the RNY. I only want to do this once!! I know we are all
different and what works for one may not work for another so do the best
thing for you. Good luck with your journey!
— Pam K.
August 7, 2002
MY INSURANCE WILL NOT APPROVE THE LAP BAND (THEY CONSIDER IT
INVESTIGATIONAL!) THEY WILL APPROVE ONLY APPROVE OPEN RNY, NOT EVEN DS. I
WILL TAKE IT! GOOD LUCK.
— Pam G.
August 7, 2002
I was told there were fewer problems with the lap RNY than with lap-band.
I had the lap RNY on June 6 2002 and am down 70 lbs. The only complication
was from my forming scar tissue. The opening between the stomach and the
intestines keeps closing. They go in with a scope and a balloon and open
it up. Easy deal...but frustrating when you can't hold down food or water.
Friday I have my 3rd endo... but most people don't have this problem.
— Thomas M.
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