Maya

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I am beside myself!! I just got approved for my lap band Yay!

I went for my initial consultation in December, My insurance initially required that I join a fitness club, have a medically supervised diet and meet with a nutritionist for 6 months before they would even consider approving the procedure. So I took out a $2000 loan because my insurance doesn't cover that and started on my 6 month journey! Only to find out three weeks in that my insurance no longer requires that!!! So... I'm out $2000 BUT I didn't have to wait so I was happy anyway!

My next hurdle was getting my letter of Medical Necessity.. My Primary Dr's office didn't have a clue about how this needed to be done, so I wrote my own letter of Medical Necessity, looked up diagnosis codes for each of my co-morbidities and took it to her so all my Dr had to do was put it on her letterhead and sign it! Yay! That was the best thing I could have done, it saved so much time and my Dr wanted to hire me to work for her! haha. I only had to wait 10 days to hear and now I'm scheduled for my Preop visit on February 4th and hopefully surgery soon after!! Woo Hoo!

Thank you GOD!

And thanks for reading fellow bandsters! >

I found out that my insurance will not cover the surgery!! And I don't have the extra money to just pay for it. (

What else can I do? Does anyone know if there is anything else I can do? This really upsets me so bad! I'm sick of being fat!!

Have your requested it and it's been denied? Do you have any of the co-morbidities? You may have to see your Primary care Dr to get these documented. If you do, you should be able to submit an appeal along with your medical records, find out what hurdles you may have to go through to get them to pay, just cuz your insurance book says it's not a covered benefit, you can submit an appeal to the medical director of your insurance.. it's worth a shot! Good Luck

My insurance company pays for the lapband, but there were so many hurdles to overcome that it was not possible to actually get them all completed. So I made the decision to go to OCC.

I asked them for a receipt I could submit to my insurance company and they had it ready for me as I was leaving the day after my surgery. I faxed it to my insurance company along with a claim form and expected it to be denies, but it was wortha shot.

I did not hear anything from them and I tracked my claim online and it was not there. 20 days later, I faxed it in again. In about 5 days, I could see it was entered and showing up online. It was showing that they needed more information about the claim.

I went to the OCC to get my first fill and and asked them for a copy of my medical records for the insurance comapny. They had it waiting for me when I got there. I was all ready to fax them in and when I got home, there was a check in the mail.

I was so excited. Granted, they got me on my deductible and out of network charges, but I still ended up with half of what I paid for the surgery. Thank you Cigna.

Thought I would share with you all.

That's so exciting!! Congratulations!!