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  577 People Lost in total 50215 lbs = 28.82 % Give us permission to add your before & after Weight Loss Photos |   |
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07-10-2006, 02:34 PM
| #1 (permalink) |
| Big Loser  Join Date: Jun 2006 Location: Massachusetts
Posts: 155
Weight Statistics 7/26/06 Start Date:
10/3/06 Surgery Date:
Height: 314 lb Start Weight:
145 lb Current Weight:
145 lb Goal Weight:
169 lb Weight Loss:
53.821656051 % % Lost:
10/3/07 Goal Date:
Body Mass Index 52 BMI Start:
24 BMI Current:
24 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass   |  Filling out the diet info paperwork Okay so I recieved all my paperwork to start to fill out. So the one question I am stumpt on is What diets have I tried? Well I put down that I was a member of a gym, and low carb, I have also put down Atkins. I did try weight watchers but it was only for 4 weeks, and didnt like the fact that I gained weight from it and the accused me that I was not following the diet! I dont really want to put them down but I know the insurance and probally going to want me to go to them for longer then what I did but I didnt like my past experience. They give me other options to check off such as lowfat, nutrisystem or south beach. I have never tried those before and was just wondering if maybe I should start south beach now so I can say that I did it. My appointment for the first consult is 8/30. I am just eating healthy and exercising today and am already down 7 lbs. in 2 weeks. Does any one have suggestions please?
__________________ Jessica  Surgery date 10/3/06   My before pictures http://s102.photobucket.com/albums/m94/JLR12679/ Follow my WLS journey here: http://tazdevil12679.blogspot.com/ My myspace website http://www.myspace.com/jess12679  |
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Yes, you can often get insurance cover for your Weight Loss Surgery. Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.  |
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07-10-2006, 02:59 PM
| #2 (permalink) |
| Seasoned Veteran  Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,755
Weight Statistics June 1, 2005 Start Date:
Height: 310 lb Start Weight:
167 lb Current Weight:
159 lb Goal Weight:
143 lb Weight Loss:
8 lb Lb Left to Lose:
46.1290322581 % % Lost:
Body Mass Index 51 BMI Start:
27 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass   | WOW thats a toughie....but i do know some insurances now DO require patients to undergo a six months to a year supervised diet program and im not sure if this is where the questions are heading to..EVERY insurance company is different. I guess I would be honest....and if they come back and say you need six months of supervised diets (weigh ins done montly by a doctor) you will have to start. HOPE all goes well and i dont wish that requirement on anyone but I know it happens! hugs
__________________ LISA  http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass  |
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07-10-2006, 03:34 PM
| #3 (permalink) |
| Guru In Training Join Date: May 2006 Location: In the country
Posts: 336
Weight Statistics August 2006 Surgery Date:
Height: 210 lb Start Weight:
141 lb Current Weight:
125 lb Goal Weight:
69 lb Weight Loss:
16 lb Lb Left to Lose:
32.8571428571 % % Lost:
August 2007 Goal Date:
Body Mass Index 38 BMI Start:
25 BMI Current:
22 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | I can attest to that. I'm still waiting to find out if my insurance is going to ask for the 6 months supervised dieting. My best advice would be to go ahead and get started on weigh-in's with a doctor, then if it's required you will be well on your way to having that time under your belt. Something else worth mentioning: don't take your insurance brochure at face value for it's requirements/criteria. Mine is requiring much more than is stated in my plan's book. I called customer service before starting this journey for approval, and they didn't tell me all the requirements, to. If you contact your insurance company, try to talk to the utilization nurse who will actually be reviewing your case, so you can get the real scoop on what they will need to give you approval.
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07-10-2006, 06:57 PM
| #4 (permalink) |
| Seasoned Veteran  Join Date: Feb 2006 Location: McGuire Air Force Base, New Jersey, USA
Posts: 2,495
Height: | I liked South Beach diet when I did it, so it doesn't hurt to talk to your doctor and get started on it so that if the insurance company does require it that you are already on your way. Good luck. Janae |
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07-11-2006, 11:38 AM
| #5 (permalink) |
| Big Loser Join Date: Jun 2006 Location: Massachusetts
Posts: 155
Weight Statistics 7/26/06 Start Date:
10/3/06 Surgery Date:
Height: 314 lb Start Weight:
145 lb Current Weight:
145 lb Goal Weight:
169 lb Weight Loss:
53.821656051 % % Lost:
10/3/07 Goal Date:
Body Mass Index 52 BMI Start:
24 BMI Current:
24 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |  So today I got up the nerve to finnally call my insurance company and ask what the qualifcations are for my plan. They told me that in order for me to qualify I would need to have a BMI of over 40 overweight for 5 years, and my doctor needs to support the WLS. So with all that being said I need to go to my doctor. She has never recomemned the surgery but another doctor I saw did. So that is my next step. The receptionist said that if my doctor doent support this then just find another doctor and to call them to recomend one that is supportive, so I guess for now I am clear. The Insurance company is even sending out my medical policy to me and I will make enough copys of it to give to all doctors. I guess I should be happy I got a nice rep at the insurance company they even spent 25 minutes on the phone with me explaining everything. Then I asked something else, it was in regards to the 550.00 program fee that I need to pay, seprate from my 500.00 copay for the surgery. I was told that the doctors in this practice are all in my network so they should not be charging me the services except for the 25.00 copay? Has anyone ever heard of this?
__________________ Jessica Surgery date 10/3/06 My before pictures http://s102.photobucket.com/albums/m94/JLR12679/ Follow my WLS journey here: http://tazdevil12679.blogspot.com/ My myspace website http://www.myspace.com/jess12679 |
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07-11-2006, 12:21 PM
| #6 (permalink) |
| Guru In Training Join Date: May 2006 Location: In the country
Posts: 336
Weight Statistics August 2006 Surgery Date:
Height: 210 lb Start Weight:
141 lb Current Weight:
125 lb Goal Weight:
69 lb Weight Loss:
16 lb Lb Left to Lose:
32.8571428571 % % Lost:
August 2007 Goal Date:
Body Mass Index 38 BMI Start:
25 BMI Current:
22 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | My doctor is "in-network", so my insurance will pay 90% instead of 80% of surgery. Maybe it's something like that.
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07-11-2006, 07:12 PM
| #7 (permalink) |
| Seasoned Veteran Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,755
Weight Statistics June 1, 2005 Start Date:
Height: 310 lb Start Weight:
167 lb Current Weight:
159 lb Goal Weight:
143 lb Weight Loss:
8 lb Lb Left to Lose:
46.1290322581 % % Lost:
Body Mass Index 51 BMI Start:
27 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass | Well things are sounding well for you. As far as a program fee...my only expenses were the copays on all the doctor visits...which were many for all the pre op clearances. I am not sure but still seems like a bargain if thats all you had to pay for a surgery thatis well over 25,000 and the great health benefits you will obtain, I would say money WELL spent. GOOD LUCK!! and do keep us posted. I dont think I am much help here but all states and insurances can be different. I have to say mine was pretty simple, the surgeon knew my insurance would approve me and they did.
__________________ LISA http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass |
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07-11-2006, 07:39 PM
| #8 (permalink) |
| WLS Guru  Join Date: May 2006 Location: Pennsylvania, near Pittsburgh
Posts: 476
Weight Statistics 11 May 06 Start Date:
Height: 310 lb Start Weight:
230 lb Current Weight:
160 lb Goal Weight:
80 lb Weight Loss:
70 lb Lb Left to Lose:
25.8064516129 % % Lost:
| I didn't have any problems getting approved for my surgery. I did go through the bariactrics center through our local hospital and at the end of my 6 months I was to pay 298.00 for their expenses. I owed nothing else once my yearly deductable was met. I had the best care where my surgery was performed... I hope you get good news and things go well., it is so hard to wait. Good Luck; ROBBIN
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