HMO Blue and lapband question!

robbie33
on 1/25/06 3:26 am - Western, MA
Hi, I have a dilemma. I have a BMI of 39.7. I have HMO Blue. I have been to see a surgeon about the lapband. My dilemma is whether or not I will be approved for the surgery. I am so close. I have to pay $750 to enroll in the program. If I don't get approved the nI only get back half of the money. Has anyone else been approved by HMO with a BMI under 40. I do have high blood pressure and GERD. Thanks! Robbie33
Caeli B.
on 1/25/06 10:32 pm - Boston, MA
Have you had your official weigh-in at the surgeon's??? Usually the one at the initial consult is what counts but if you haven't yet... the difference between 39.7 and 40 is how many sweaters you're wearing and whether you've got your shoes on, etc. Or if you're almost 5'6", tell 'em you're 5'5" instead. Or indulge in one last meal. Seriously. We're talking literally a few pounds. Good luck, Caeli
robbie33
on 1/26/06 2:50 am - Western, MA
Unfortunatley I have had my initial weigh-in. I am hoping that the hypertension will help. I also have heartburn so the doctor put down GERD. Maybe that will help. I just feel that I am so close. I haven'e looked into other doctors. I didn't think there were any in my general area. Do you guys know of any? Robbie33
nancyMA
on 1/27/06 3:15 am - granby, MA
Robbie, Are you near springfield? If so, there are 2 options. One at Mercy Medical Center, that is a weight management thatprogram. My husband goes there and gets GREAT service and support. Their fee is 325. I went to a private surgeon at Baystate and they give you a manual of what requirements you need to complete prior to beginning the insurance approval process. I than took the info and made all my appoints with nutritionist, psychiatrist and attended 2 support group meetings. Met with my primary MD than I submitted all the info to the surgeon. They sent out the paperwork to the insurance and I was approved 9 days later. I do know that going through a weight management program you definately get more support during the process. Is that worth 750.00? Maybe it is, only you know for sure. Hope that helps Robbie. Nancy
robbie33
on 1/27/06 4:49 am - Western, MA
Nancy, I am about 1 hour from Springfield. That isn't that bad but I also have 4 kids and work full-time so it wouldn't be easy to go for fills and things. The other doctor is only 15 minutes away. I am not sure the program is worth $750.00 but if I have to do it I will. I just don't want ot lose half of it if I don't get approved. If they could just assure me that I will get approved I would fel better. I know some people have to pay thousands of dollars so I shouldnt be whining. Thanks for your input. Robbie33
Carrie N.
on 1/27/06 10:22 am - Pigeon Forge, TN
Caeli, I have not seen you here in a long time. You look great! Congratulations! Carrie
Caeli B.
on 1/27/06 11:08 am - Boston, MA
Thanks, Carrie! Feeling great too. Just read your profile and you've done awesome yourself. WOO HOO for us both! Caeli
nancyMA
on 1/26/06 1:02 am - granby, MA
Hi, My BMI was 38 and I was approved after the first submission to HMO BLUE. I also have hypertension. I had surgery on 1/20/06 in Springfield. I see you live in WMass. Have explored other facilities that don't charge a fee to enroll? NancyMA
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