Newbie with some questions.....

Hello -  I am just starting my journey and just found the Arizona board.  I have my first appointment tomorrow, with Dr. Nirmul.  Here's my questions: Has anyone used Dr. Nirmul?  What was your experience with him.  It shows that he specializes in Lap band only which is what I am looking for. My husband is a new employee with the state  of Arizona - we have Schaller Anderson insurance through his job.  I have Aetna through my job.  I am planning on dropping mine at the end of the year.  So my question is, what experience has anyone had with either insurance.  If I go with Aetna, any chance I could be approved by the end of the year?  If not, do you think Schaller Anderson would approve and what is the timeline.  Do both require 6 months of supervised diets?  What does this consist of.  As you can see, I am full of questions and looking for all the support I can get.  By the way, I am a mother of 2 girls ( 3 and 5) and live in the far NW Valley - close to Vistancia and Lake Pleasant. Looking forward to getting to know you all. Thanks - Jodi

Hi Jodi, Sorry I can't help you with the insurance issues but logically I'd call both companies and ask the hard questions.  Starting with IS IT COVERED?  I'd say know your BMI when you call as alot of insurance say you have to be above a certain BMI.  In addition I don't know Dr. Nirmul but I can tell you many of us on this site have used DR. TERRY SIMPSON.  He just does Lap Bands but used to do all the barriatric surgeries.  He also helped to perfect the new Lapband II with Alergen.  I can't tell you how much I like and respect this man.  He is a gem of a Dr.  Very personable, professional and most of all caring.  I had a small concern 2 days after my surgery, I wrote an e-mail and he called me back personally on a Sunday.  Best of luck to you and I hope you can get approved quickly.  The band is the best thing I've ever done. 

Hi there, Yep I would ask if they cover any WLS and if yes which ones they cover. I would also ask about what surgeons they cover under. I know many insur. comp. will only cover surgeons  that are Centers Of  Excellence. I know AZ has three centers, with the 4th coming soon from what I understand. I did a TON of reading and educated myself on everything concerning the kind of WLS I was having. I was with Blackstone for over a year trying to get approved. Time came and I knew we would be paying for WLS ourselfs so I interviewed 9 surgeons.  Other then the surgeon I hired: Hilario Juarez M.D. St. Lukes Medical Center 525 N 18th Street Fl 3, Ste 306 Phoenix, AZ 85006 Phone: (602) 252-1510 Fax: (602) 256-9488 I would have gone with:  Eric S. Schlesinger, M.D., F.A.C.S 20950 N. Tatum Blvd., Suite 380 Phoenix, AZ 85050 Phone: (480) 419-2280 Fax: (480) 991-6615 Both are just amazing.  I hope you learn all the info you need to make this life changing choice!

Beware of switching to the State insurance. I don't know about Aetna, but as a state emplolyee you do have to do the 6 month diet along w/ a new requirement of attending support groups. In addition they require a BMI over 40 PLUS a severe life-threatening illness like uncontrollable diabetes or sleep apnea. Everyone says it is very hard to get approved and I am just finishing out the new support group requirement and then my packet will be submitted. I would find out the Aetna requirements and see if might be better to stick with that until surgery and then switch at the next enrollment period for the state. Rebecca

Yep, I was working at the AZ Attny. Gen. Office when trying to get approved! Total run around.