Hello....I am new to...

Hello....I am new to the forum and not quite sure how to start, so I will just jump in. I am very interested in the lap band surgery but am a little nervous about having my insurance pay for it. I have Aetna open access. Even though I have been seeing a doctor for the past year for weight loss advisement, she just started my six month "physician" assisted program. I really dont want to wait another six months to get this thing going. I have several morbidities, including type 2 diabetes, high blood pressure, high cholesterol, sleep apnea and I am 257 pounds at 5'6". The last round of meds she prescribed for my diabetes, ( I am newly diagnosed), put 25 pounds on me in just 2 months. UGGGH I am soooo uncomfortable now, this was the last thing I needed! Any advice would be great, I have looked into Dr Mehta in New Brunswick and Dr Andrei in Livingston, but haven't been to see either yet. Do I really have to wait 6 months? Thanks again to all who answer this. P.S> i am in the East brunswick area. Sorry this is too long!

hi and welcome yes if your insurance says you have to do the six month thing, than u have to go thru it. in the meantime it is good that your are working with a physician and she is documenting what you are going thru. sorry about the diabetes meds putting on weight for you. maybe the doc needs to adjust your dosages?? i would certainly start the ball rolling with a surgeon, so hopefully u can get in and get going once you have done your six month project. also a surgeon will be able to advise you in whether a lap band or an RNY is the best procedure for you. good luck, jacki

Hi, Eileen, I feel your pain, I,too had Aetna open access and you do have to follow their protocol.The more you do to the letter the better off you will be when it comes to getting approved.I know it really sucks, but that is the way it is.Once you meet their requirements you will have no problem getting approval, Good luck, Toni

Hello Eileen: I had Aetna HMO and had to do the 6 month thing but it had 2 be in the last 2 years so you might be ok. I had to get copies of the doctors notes and I was ok. I went to Dr. Biloff in West Orange he was great he is out of St. Barnabus.Attached is my email if you have any questions [email protected] it looks like I have all the morbidities that you have since the surgury almost everything is gone.

Hi Eileen, I also have Aetna Open Access and was required to do the six month diet, so if that is what the insurance required, there is no way of getting around that. Six months may seem like a long time, but in all honesty, it will fly by quickly. Dr. Bilof was also my surgeon and he's a wonderful. Best of Luck, Carla

Even though it seems like a long time it really does go fast. Also, use the time to learn all you can from these forums. I am glad I had to wait as I know so much more now than I did when I first decided to get the surgery,

welcome aboard i too have aetna and did the 6 month diet -- it flew by --it also gave me time to educate myself and do more research -- it also gave me time to change surgeons -- and it gave me time to have medical procedures done for a different illness -- so it was good that i had the time -- i was approved in 2 weeks -- was approved in june -- surgery was scheduled for october -- blood work came back not too good -- had to wait until november -- it was all a blessing in disguise take care roberta

My insurance company wanted a 6 month physician supervised program, but with all of my failed diet attempts, I was able to piece together - with the help of my PCP - enough documentation. But, my insurance company ended up not needing anything but the word of my doctor. If I were you, I would make an appointment TODAY with a surgeon. I saw Dr. Michael Nusbaum in West Orange - a WONDERFUL doctor. But, if you call today, get an appointment in a couple of weeks, by the time you get all your testing done and insurance approval, etc., you may be at the six month window anyway. I went for my first visit with Dr. Nusbaum in March, and had my surgery on August 1st. So, it does take a little while for things to get going.

Hi eileen, I had the lapband done on the 15th of March by dr andrei.He is a great Dr.When I had my first fill on the 18th of April I had lost 22 lbs.That was 3 weeks ago. I believe I am now down 30 lbs total.I am not 100% sure since I dont have or want a scale at home.I go back for a fill on the 30th of this month so I will see what the total is then.If you would like any info or have any questions feel free to ask sean

I HAD LAPBAND DONE IN FEB. YOUR INS MIGHT ASK FOR THAT, BUT IF YOU START THE BALL ROLLING NOW WITH THE SURGEON AND WITH ALL THE THINGS YOU HAVE GOING ON, THEY MIGHT APPROVE IT AFTER 3 MON ASSISTED PROGRAM. YOU HAVE A LOT GOING ON. THE SURGEON IS GOING TO BE COLLECTING LETTERS FROM EVERY DOCTOR THAT YOU SEE. PLUS THE SURGEON WILL ASK FOR CERTAIN TEST TO DONE. WHEN THEY HAVE ALL THAT TOGETHER, THEY WILL PRESENT IT TO YOUR INS. CO. YOU DON'T HAVE TO CALL , YOU DON'T HAVE TO WORRY ABOUT IT. THEY KNOW HOW TO DEAL WITH THE INS. CO. AND WILL TELL YOU WHAT YOU NEED. THAT IS WHAT I DID, I GOT MY REFFERAL FOR THE SURGEON, THAN HE GAVE ME A LIST TO COMPLETE. EVERY DOCTOR I SEE SENT A LETTER. I DO NOT HAVE DIABETES. I HAVE ARTHRITIS , ASTHMA, BLOOD PRESURE. I HAVE "AMERIHEALTH" I WAS APPROVED IN 24 HOURS. SO GET GOING???? YOU MIGHT HAVE TO ATTEND A MEETING BEFORE HAVING YOUR APPT. SOME SURGEONS WANT THAT ALSO. GOOD LUCK BRIDGET K. "NOBETTERWOMEN".. it is an irish thing!!!