Question:
Inusrance won't approve the lap

not sure what to do I did want the lapband bt my INC dened it so i dont know eather to fightthem or not bt the do aprove for the gastric bypass not sure if they would for lap but iam sure they wuld but what i would like to know is their any one that has had the LAP RNY an did ot have any problems with it? Please anwser here or e mail me I have got to do something an if all i can do is the lapRNY then i will do it but it just scares memore than the lapband    — wildbrat (posted on August 7, 2002)

August 7, 2002
Beth I struggled with this issue myself see my profile. I finally settled on the RNY and am glad I did. My wife needed wls too and with her extremely high BMI my surgeon said the and wouldnt be as effective. I figured we should both be the same but what REALLY convinced me was a bandster I spoke with on the phone. He sid he would like a whopper but was settling for shakes instead. :(:(:( I loved milkshakes and they are band friendly. THe RNY with the icky feeling is much better for me. Truly dont worry, post op is the place to be!
   — bob-haller

August 7, 2002
I think your insurance won't cover it as it is a fairly new in the states. When I first started looking into WLS I was thinking Lap-band all the way but the stats just weren't good enough for me. Then I read about some folks who had problems with it falling off which caused some complications. I suppose it's true that there is no such thing as a risk free surgery! I chose to have the laproscopic Bypass and will go in for surgery on 11/11! I'm scared but excited to start a new life. Good luck in your decision!
   — Colleen S.

August 7, 2002
I have just had lap RNY. My insurance provider (Cigna) approved on the first letter 2 days after receiving it. I do have several comorbidities though that helped in their decision. I am diabetic, have high blood pressure, high cholestrol, mild sleep apnea (Don't need CPAP machine)and other minor problems. You may need to have tests done prior to surgery. Have you talked to your PCP? Have they recommended you for surgery? It seemed that I couldn't jump enough hoops with the DRs before I was sent to see Dr. Murayama my surgeon. Cigna would only approve if letter was from surgeon. Good Luck
   — Candice B.

August 7, 2002
Hello all, I'm a benefits manager and have to deal with HMOs all the time. HMOs all work a little differently but generally the HMO pays your PCP just because he/she is listed as your PCP. In other words, even if you never see your PCP he still receives payment from the HMO. However, if a PCP refers a patient to a specialist they can lose money. Unfortunately, this may be the case with your PCP. Then again some Doctors just close their mind to WLS. Either way it should be your choice! Find another doc!!
   — Colleen S.

August 7, 2002
I had the lap RNY. The band is fairly new and a lot of insurances are not covering it yet. My Dr had just started doing them. The reason I chose the RNY is because I wanted the extra tool of dumping and NOT being able to eat sweets, ice cream and all the fatty things. I had no control over these. I have not tested to see if I would dump with them, I'm satisfied just knowing I should dump and for the past 9 1/2 months that has been good enough for me. The weight loss proven to date in the US has been much better also with the RNY. I only want to do this once!! I know we are all different and what works for one may not work for another so do the best thing for you. Good luck with your journey!
   — Pam K.

August 7, 2002
MY INSURANCE WILL NOT APPROVE THE LAP BAND (THEY CONSIDER IT INVESTIGATIONAL!) THEY WILL APPROVE ONLY APPROVE OPEN RNY, NOT EVEN DS. I WILL TAKE IT! GOOD LUCK.
   — Pam G.

August 7, 2002
I was told there were fewer problems with the lap RNY than with lap-band. I had the lap RNY on June 6 2002 and am down 70 lbs. The only complication was from my forming scar tissue. The opening between the stomach and the intestines keeps closing. They go in with a scope and a balloon and open it up. Easy deal...but frustrating when you can't hold down food or water. Friday I have my 3rd endo... but most people don't have this problem.
   — Thomas M.