Hello All

Hello All,

I am new here but been lurking for a bit.  Tuesday I attended the informational seminar for the lapband have decided this is the direction I would like to go in.  I have been fighting obesity all my life and I hoping that this tool will help me keep the weight off.

One of my major concerns is what my insurance will cover.  I do know they will cover WLS for medical reasons and I fit the criteria.  I have a BMI well over 40 and in fact it close to double that.  My insurance which is Cigna btw requires a 6 month DR monitored diet as part of the criteria so I do know this will take a lot patience and time as I will need to do that.

I am not too concerned with the diet as I know I can drop weight.  My problem is keeping it off.

I am concerned about whether or not Cigna will cover all the appts needed for example my initial consult with be with a Nurse Practioner and a Nutritionist.  Then at some point I will meet with a mental health counselor.

I have done a lot of research online and I am currently reading JeanM's book Bandwagon which is excellent by the way.  So I am ready to move forward.  My appointment is for Oct 12.

thank you...Jim

Jim best of luck with everything. Keep us updated. I just started my journey also. I just made my first meeting appointment.  where are you going to have you lapband done?

Best wishes to you both! You are in "good hands" with the Bandwagon book. You will have to check with Cigna for what they will specifically cover. K

Welcome, Jim.

If I were you, I'd call Cigna's customer service line and ask for a written copy of your policy's coverage for weight loss surgery and also for specifics of what related services they will or won't cover. (Idiotically, some insurance companies will pay for band surgery but not for fills.)

Also, if your surgeon's office has an insurance specialist, that person should be able to get some specific info from Cigna about your coverage and to submit claims in a fashion that will ensure their approval. I met an insurance specialist at the OH event in WA in July who said that careful coding of claims can be crucial in getting the insurance company to pay for the services you need.

If things are still fuzzy after that, let me know and I'll give you contact info for a bandster who used to work in insurance and now does a lot of volunteer work in helping bariatric patients with insurance issues.

Good luck!

Jean

P.S. I'm glad you like Bandwagon!

Jim,

I have Cigna and they have worked very well with all of my appointments and now with my fills. Jean is right, call Cigna and talk to them. They assigned me a phone nurse that stayed in contact with me through the approval process.
It is nerve wracking waiting for the approval, just hang in there.

Diane

I believe as long as they cover bariatric surgery they will cover the monthly check in with the doc, at least they did mine. I also have to give my standard warning that if you have a great deal of weight to lose you might want to consider a different surgery because the band is the least successful and slowest method of weight loss. Just trying to save you the disappointment I've gone thru with my band, a 20 lb. weight loss in 3 years! Not so effective and yes I followed the rules and ate absolutely what I supposed to, just never had consistant restriction so the band didn't help. What I lost was due to my own hard work not the bands help. Anyway welcome and you are off to a good start with Jean's book. I've had the honor of meeting her and she's a-one ( even if she is skinny).

Hi Paul,

Sorry to hear things did not work out for you with the lapband.

I do have a significant amount to lose. I weigh in 480 at 5' 7.  Losing weight have never really been a problem for me it's keeping it off so I am hoping the lapband will help in that area.  I know the lapband is a tool and will require a lot of work.

In 2003 I weigh 393 pounds and managed to drop 174lbs in 19 months doing Atkins and exercising.  Unfortunately I gained it all back and then some.  I am hoping with the band and hard work I can get it off again and hopefully learned  from my past missteps.  I also plan to attend meetings as often as possible for the rest of my life to help keep my weight issues in perspective.

I do appreciate your insight and will certainly discuss these things with the doctors before diving in head first.

thank you,  Jim

~I know the lapband is a tool and will require a lot of work.~

That is just partially true. The band is a tool for SOME. For thousands of us out there that are stuck with FAILED Lap-Bands there is NO "tool"! Kind of like trying to fix your pipes with a broken wrench..........kind of useless!

Please read the revision forum. Look and see how many bandsters have, or are in the process of revising FROM the band! Do you honestly think all those bandsters would be wanting to put theirselves through the pain and expense of yet another WLS if the band were that great???

Hi Maria,

I do thank you for your insight on this.  I have already decided long ago that I will absolutely not alter my anatomy to lose the weight. 

I will continue to weigh (no pun intended) the pros and cons as well as reading the experiences on the various forums.  I will also raise all my concerns to the professionals.

thank you, Jim
 

Hey Jim, best of luck in your journey.

If you've lurked for any amount of time on here, you probably know that I am one of the many who experienced complications with my band and decided to get it cut the heck out. If you didn't know that already, there is my quick disclaimer! lol

But aside from my personal bias, you should know that the band does alter your anatomy. Adhesions and scar tissue are inevitable. It also creates a pouch instead of your natural working stomach complete with pyloric valve. Definitely discuss these changes and what it could mean for your esophagus when you speak with your doctor. Another good question would be to ask how many band removals your surgeon is performing.

I have a hard time understanding why so many people want to keep their oversized stomachs. I am so happy to be free of mine that I can't believe I lived with it for so long. If my appendix burst, cut the sucker out! If I get skin cancer, cut that thing off! If my oversized stomach is killing me slowly via morbid obesity, let's cut it out! (well, 85% of it anyway!)

Oh well, I must have understood the defense of the large stomach at one time as I initially opted for the band as well.

I'll stop rambling now. I sincerely wish you all the best in whatever route you take. Although the 6 month diet seems like an annoying delay, it does give you the benefit of time for research to be sure you are making the best decision for you.

Keep us updated on your progress,
Lindsey