Weight Loss Surgery - Waiting For Insurance Approval




View Full Version : Waiting For Insurance Approval


MadCowOnTheMend
03-05-2013, 10:33 PM
Hello, I have just joined today and am looking forward to getting to know others here. I submitted all of my clearances for insurance approval last week and now I'm on pins and needles waiting for their response.
I'm starting the pre-op diet to prepare, even thought that feels like it may be a few weeks premature. My nutritionist seems to think I have a pretty simple case and god insurance coverage.

Anyone care to share experience or advice?


thinkfit
03-05-2013, 10:50 PM
Awesome! I'm so excited for you, it sounds like hopefully insurance shouldn't be a problem and soon you'll get the go ahead! :carrot: If you don't mind, can I ask which procedure you're getting done?

MadCowOnTheMend
03-05-2013, 11:02 PM
I have a very large para-esophageal hernia that needs to be repaired during the procedure, so I am only a candidate for the gastric bypass. No banding or sleeves due to the high risk of re-herniation.

My current BMI is 42 so I am just above the lower limit for my insurance, although I do also high blood pressure as a comorbidity. They consider the combination of 35 BMI and high BP as adequate for coverage, but I have not been on blood pressure Jed's for long so we are assuming that they will look at me for needing a 40 BMI to qualify for coverage. Due to my other health issues, we have already met my $2500 deductible for the year so, if approved, I'm covered st 100%.


thinkfit
03-05-2013, 11:14 PM
So sorry to hear about your complications, it definitely sucks but it's always great when it's something that can be helped! I'm no expert, but it sounds like the odds are in your favor as far as insurance goes. Fingers crossed!

jiffypop
03-06-2013, 12:18 AM
welcome to our little corner of 3FC! sounds like you have all your ducks in a row - congratulations!

my one piece of advice: the first three months ARE NOT EASY, but just face each day as it comes and get through it. it WILL get better. i promise.

oh wait. ANOTHER big piece of advice: attitude is everything. If you decide that the road is difficult and that you're being punished or you feel defeated, well, guess what happens. But if you take the attitude that you're hitting the RESET button on everything you ever thought you knew about food and eating, and that you will figure out how to live with the surgery - and live well - you'll get through it better, happier, and more healthy.

As a group, we're NOT good at taking care of ourselves. Surgery forces us into a position where we HAVE TO. and it's not always comfortable.

MadCowOnTheMend
03-07-2013, 06:04 PM
Surgery scheduled for Monday the 18th. I can't believe it only took them a week!!!

Now to figure out what to do with 4 kids for a few days... and my husband is scheduled to go out of town the end of that week. We'll see how this goes.

MadCowOnTheMend
03-07-2013, 06:11 PM
Surgery scheduled for Monday the 18th. I can't believe it only took them a week!!!

Now to figure out what to do with 4 kids for a few days... and my husband is scheduled to go out of town the end of that week. We'll see how this goes.

thinkfit
03-07-2013, 07:24 PM
Omg you have a date! That's so exciting!!!!!

Hope you can find someone to watch the kiddos!

jiffypop
03-07-2013, 11:34 PM
congrats!!! that was FAST!!!!! and it's happening, like a week from monday [tuesday?] WOW!!!!

MadCowOnTheMend
03-08-2013, 05:30 PM
YEs! They told me that my hernia meant they it would go quickly, but wow! I kept holding back any expectations because I thought they were trying to be encouraging.

It's a good thing that I started that pre-op diet last Monday!!

This morning I had my bloodwork and paperwork done, as well as a 2 hour prep class for surgery and lifestyle change. It was encouraging.

I was down 5 lbs total this morning on their scale (243) since Monday. They are re-doing the upper GI scope on Wednesday to get a look at the hernia and scar tissue and then I'm ready!

jiffypop
03-09-2013, 09:21 AM
WOW!!! and you're so ORGANIZED!!! even with 4 kids! can you tell us about the 2 hour prep class? i didn't have to do that, but heck, mine was 11 years ago - almost the dark ages in this surgery - and i'd love to know what they're telling people.

thinkfit
03-09-2013, 02:51 PM
^ I'd also love to know about the prep class! :)

MadCowOnTheMend
03-09-2013, 05:34 PM
The class was somewhat of a joke, but it is a requirement. There were 8 of us in the class all having RNY or the sleeve. They went over the process of the surgery, risks, side effects and detailed discussion of the after care and diet progression for the next year.

The sad part is that most of the other people in the room didn't ask any questions. At the end, they started joking that they should hire me to teach the class. I guess I AM really prepared!

My surgeon has been in practice for over 25 years and his office and facility have the Center for Excellence designation. I did a lot of research on that, too. :-)

thinkfit
03-09-2013, 06:22 PM
Not gonna lie, considering for insurance I've had to go to the seminar (where I received a book with anything you could ever want to know about their process), six months with a dietitian where I can ask any questions whatsoever about the surgeries/diet afterwards, and then the meeting with the surgeon to talk about everything before I schedule, I thought it was a little silly that we've also got to go to a class after we get a date to get informed - uh, hello, I've had six months to do that! haha. Good to know there won't be any curveballs!