Got a date

mpafford
on 8/26/13 4:26 am - TX

Not sure. Since the EGD was just done on Friday, the Dr.s office is submitting paperwork to the insurance company today showing the damage the band has caused.

I am still considered self pay, but if they will pay for the removal it will save me about 4-5k.

Nothing in my plan of benefits saying that removal is not covered. It is directly causing my GERD.

we shall see.

Montie P
Lap band 3-4-05 starting weight 312 now 190
LBL/BL  w/lipo            6-18-08
Arm/Thigh Lift w/lipo  1-07-09

Sometimes losing is really winning!
MSSEXXC74
on 8/26/13 4:40 am

Oh ok well good luck I hope everything works out for you! I don't know what all consists of taking the band out but it seems like to me 4-5k is a lot considering they will already have you open to do the WLS  and the OR and anesthesia will already be paid for.  Its like are you serious??  Two fields of work that are always going to be prosperous are medical and law enforcement.  The doctor could even do it for free and write if off at the end of the year. But I understand they have bills also. My mother is a RN and her best friend is an ER Doctor.   Well he had to have a major surgery and ended up in the hospital with bills totaling 96k the hospital and all the doctors wrote it off and just used it on their taxes. But it sounds as if he feels pretty confident that insurance is going to approve it since he already scheduled you.

mpafford
on 8/26/13 4:47 am - TX

They told me that if they go in and find a hernia, that will be an additional charge to my insurance.

The removal is be the biggest part of the surgery, as they said I have a lot of scar tissue to work around.

I just want my insurance to pay something!!!! Of course, this is why our insurance is so expensive and goes up every year.

I was self pay for the band, my 2 rounds of PS, and now this. I could have bought a house for all this.

But the band is making me sick and not sleep at night. I wish I could do this on my own, but I know I had tried everything before and gained it all back.

Hopefully this will the the last time for WLS.

 

Montie P
Lap band 3-4-05 starting weight 312 now 190
LBL/BL  w/lipo            6-18-08
Arm/Thigh Lift w/lipo  1-07-09

Sometimes losing is really winning!
MSSEXXC74
on 8/26/13 5:34 am

OMG I am so sorry that you are going through all of this> It kind of makes you wonder why the heck pay for insurance if they are not going to be there and be reasonable when you need them.   Im not saying anything about the recipients but it almost seems like they punish us. In your case it evens seem like it may become a life or death situation since it is actually doing damage to you. What if you were financially not able would they still drag their feet.  Plus all they know since paying for the initial WLS you may not be able!   I do have to say i thank God that CIGNA has been good to me through the years especially since me and my son have every medical aliment you can think of.  Keep us posted on what they say.

Member Services
on 8/27/13 5:20 am - Irvine, CA

We are doing the Happy Dance for you!

 

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