Anyone have recent experience with AHCCCS/APIPA insurance?

Hello, I am new to posting, but have been lurking for 3-4 years and I am ready to take the plunge. I am nearing the big 3-0 and am the mother of 2 wonderful kiddos that deserve to have a mommy that can actually LIVE life with them rather than watch it pass by. If anyone has any recent experience dealing with approval/denial through AHCCCS/APIPA, please post your experience or a link to it. Also, does anyone have any opinions on which type of surgery is "better"? I am trying to decide between Lap Gastric Bypass and Adjustable Lap Band. Thanks in advance! M

I'm pretty sure no insurance companies, including AHCCCS, cover lap band. I have a friend who is attempting to get Mercy Care to pay for the surgery right now. They put a lot of barriers in your way, but from what I've heard, you just have to be persistent and they eventually will pay. If you're lucky, your youth will pay off in giving you that time to get through the beaurocratic hoops. Be sure and keep a journal of all your doctors' appointments and what was done and said as regards the surgery. If any issues come up in the future, that gives you ammunition in a dispute. Be prepared to go to war with the system and you will surely get there sooner or later. Good luck. - Stephanie J

Welcome aBOARD, MT! Glad you posted. Personally, I feel that gastric bypass is more effective long-term if you are 100+ lbs overweight. Most insurance companies do not cover lap-band, and I know APIPA has strict guidelines. I urge you to contact APIPA and find out what your coverage is for weight loss surgery. They can send you a website link or a page or two of policy that details what you need to provide them (basically you provide the surgeon and the surgeon provides it to APIPA). I have Aetna, but even with Aetna there is so much red tape and hoops I have to go through. Ugh! So don't get discouraged! post here often for support and help. We are here for you! God Bless, Trisha in Phoenix

I appreciate your replies! I actually tried to contact APIPA about it (2 different times hoping I would get a straight answer) and they told me that they don't have a list of guidelines they use (which I know isn't true) and I would need to see my Doctor to answer any other questions. Makes one's head spin to have to go through all the red tape to even get answers let alone approval. Another thing I forgot about it the fact that come August I will be on Medicare also, so I wonder how all that would play out when it comes to approval. I already know I am physically eligible due to my weight (305lbs, 5'7") and history of heart disease and diabetes in my family, as well as elevated cholesterol in myself...it's just so overwhelming to think of all that needs to get done just to have the surgery. I guess I really can't complain though- time will pass and be wasted regardless of whether I am attempting to get approved or not...did that make sense? In the back of my mind I guess I still hope I can lose it on my own, as I have lost nearly 50 pounds since July after my dad suffered a heart attack (and he was at a healthy weight!)...but it is just seeming like an endless and overwhelming task. Ok- I think I have ran on long enoguh. Thanks again for the advice!