getting started

Ok here goes some Q's Has anyone got covered by Regence/ Blue shield in Washington state ? My hand book says it will not cover lapband ?If you know how to do it please let me know thanks Tony

Tony, I can't really answer question's about Regence/Blue shield as I am covered by Aetna. What I can tell you is Aetna recently changed in March to where they will now cover the lapband procedure. Have you called the number on your insurance card? They can likely give you the most up to date information. Dan

A co-worker of mine was denied for lapband surgery due to it being too new and there not being a lot of long-term studies. I think another reason they gave was because of the long term weightloss numbers....meaning, how much a person lost and how long they were able to keep the weight off, etc. As with any new type of procedure, especially an expensive one, insurance companies don't like to get involved it has been "proven". They also told her the risks of stomach erosion, etc was too high. Due to her co-morbidities, she decided to go on with a lap RNY...all she had to do was re-submit a couple of forms with the change of surgery and coding numbers.....A few weeks later she was having the surgery and is doing fantastic. If you truly want lapband, then you can always check in on "self-paying" or going out of the country. Down side of going out of the country is the fact that you probably have no way of go after a doctor who goofed up, unlike here in the states. Hope this helps.....and keep those questions coming Beth

Hi Tony, I went out of country to Mexico to be banded. I can honestly tell you that the doctor I went to, along with the rest of his team, was one of the best in the business. And while as one of your replies states one reason not to go out of the country is that you can't "go after" a doctor for something going wrong, I do know that Dr. Kuri and his crew actually have a very good track record, and they will take care of problems-- usually free of charge. As far as the risks of the band, once the news is out the insurance companies will be in a rush to move. And I am sure it won't be long in coming. The risks assosciated with the band are minimal. The procedure much less invasive. The cost is about half of what it costs here in the states. The hospital is brand new, the staff caring and professional. None of the "too busy for your problems" attitudes as we find here in the states. If you don't get your insurance question answered to your satisfaction, and self-pay is an option (at a lower rate) consider Dr. Kuri. If you would like his number email me directly. Good Luck on your journey and never give up!! Kelly