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  897 People Lost in total 77828 lbs = 28.71 % Give us permission to add your before & after Weight Loss Photos |   |
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07-12-2008, 04:28 PM
| #1 (permalink) |
| Whipper Snapper Join Date: Jul 2008 Location: Brooklyn, NY
Posts: 18
Weight Statistics 7/12/2008 Start Date:
5' 5"
Height:
325 lb Start Weight:
323 lb Current Weight:
150 lb Goal Weight:
2 lb Weight Loss:
173 lb Lb Left to Lose:
0.615384615385 % % Lost:
Body Mass Index 54.0769230769 BMI Start:
53.7441420118 BMI Current:
24.9585798817 BMI Goal:
 |  My Insurance Excludes Bariatric Surgery
Flat out, said they won't cover. Although in NYS it is illegal for an insurance company to not pay for surgery if it is deemed medically necessary?! I have Blue Shield. Sigh. I hate my employer. Anyone else in this situation? I'm this close to going to Mexico.
__________________ Janice B Joined 7/12/08 Weight: 325 BMI: 51  |
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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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07-12-2008, 05:31 PM
| #2 (permalink) |
| Seasoned Veteran  Join Date: Dec 2007 Location: Buffalo, NY
Posts: 2,465
Weight Statistics 12-19-07 Start Date:
1-29-08 Surgery Date:
5' 3"
Height:
286 lb Start Weight:
164 lb Current Weight:
150 lb Goal Weight:
122 lb Weight Loss:
14 lb Lb Left to Lose:
42.6573426573 % % Lost:
eventually Goal Date:
Body Mass Index 50.6570924666 BMI Start:
29.0481229529 BMI Current:
26.5684051398 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass  |
There's a couple. Kitty56 and Trulykath come to mind. They'll be on soon. I'm sorry.
__________________ Kelly  5'3"    |
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07-12-2008, 10:06 PM
| #3 (permalink) |
| Big Loser Join Date: Jul 2008 Location: Twin Cities, Minnesota
Posts: 126
Blog Entries: 1 Weight Statistics 1999 Start Date:
OPEN RNY 4/6/1999 Lost 150# Surgery Date:
5' 7"
Height:
304 lb Start Weight:
179 lb Current Weight:
178 lb Goal Weight:
125 lb Weight Loss:
1 lb Lb Left to Lose:
41.1184210526 % % Lost:
Already hit my goal of 154lbs No hurry Gained 25 per MD orders @ 2yrs postop MAINTAINING NOW! Goal Date:
Body Mass Index 47.6079304968 BMI Start:
28.0323011807 BMI Current:
27.8756961461 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass   |
I have BCBS also, and they cover it in Minnesota. Must be just the differances in policies.. Yep, dont despair, there are ways to still go thru with your goal. The self pay really isn't that bad. Usually payments can be made, It differs per hospital what they charge, so check around, its amazing what some places charge, while others are so much more nicer, and have a great track record of WLS.
__________________  minnesotashopper2 Lori RNY 4/6/1999More photos of WLSjourney-myspace. www.myspace.com/royaltyshoppingIf you would like to add me to your myspace page, please add a note telling me your from this site. I love new friends! |
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07-12-2008, 10:14 PM
| #4 (permalink) |
| WLS Guru Join Date: Aug 2007 Location: Michigan
Posts: 394
Weight Statistics 07/25/07 Surgery Date:
5' 8"
Height:
288 lb Start Weight:
201 lb Current Weight:
160 lb Goal Weight:
87 lb Weight Loss:
41 lb Lb Left to Lose:
30.2083333333 % % Lost:
08/2007 Goal Date:
Body Mass Index 43.785467128 BMI Start:
30.5586072664 BMI Current:
24.3252595156 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
My insurance also did not pay so I paid cash for it but well worth the money spent/ I think I paid about 30 grand once everything was paid for. Most places do give cash patients a lower price than if your insurance was paying, Good luck, you will find a way.
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07-12-2008, 11:11 PM
| #5 (permalink) |
| WLS Mentor  Join Date: Feb 2007 Location: No. Los Angeles County, CA
Posts: 1,353
Weight Statistics 4.29.08 RNY Surgery Date:
5' 8"
Height:
301 lb Start Weight:
204 lb Current Weight:
170 lb Goal Weight:
97 lb Weight Loss:
34 lb Lb Left to Lose:
32.2259136213 % % Lost:
Body Mass Index 45.7618944637 BMI Start:
31.0147058824 BMI Current:
25.8455882353 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
Blue Shield covers...the employer put in the exemption.  That sucks all over the place. One reason...there is no guarantee that the employee who has the surgery will hang around long enough to make the extra cost worth it. That is what I have heard, anyway. Still sucks.
__________________ Judijo  7/2008: I no longer qualify for WLS! BMI <40 with NO co-morbidities!  9/29/08: 5 months post-op and 70 pounds gone forever, babeeee!  11-29-08: 7 months post-op and down 90 lbs. Total cholesterol is under 200 for the first time in my adult life!   Starting weight: beginning of nutrition classes, August, 2007 My blog on my weight loss journey and thoughts that go with it. My MySpace Page. |
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07-12-2008, 11:40 PM
| #6 (permalink) |
| WLS Master Guru  Join Date: Mar 2008 Location: Rochester, NY
Posts: 869
Weight Statistics March 12, 2008 Start Date:
December 4, 2008 Surgery Date:
5' 3"
Height:
259 lb Start Weight:
229 lb Current Weight:
135 lb Goal Weight:
30 lb Weight Loss:
94 lb Lb Left to Lose:
11.583011583 % % Lost:
Body Mass Index 45.8747795414 BMI Start:
40.5610985135 BMI Current:
23.9115646259 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
That is really awful... I'm so sorry. I'm in NY with BCBS Healthy Blue and they're covering it for me. Can you appeal to your employer?? Maybe make contract that you'd keep working there for X amount of time if they'd cover the surgery?? Write a letter stating what a better employee you'd be if you were healthy?? Not as many sick days (if you take any), better attitude, better representative of your company, etc. Just an idea.
__________________ Martha My top 2 reasons for WLS... Joshua and Jessie.  13 lbs lost before surgery.  |
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07-13-2008, 12:26 AM
| #7 (permalink) |
| Big Loser Join Date: Sep 2007 Location: California
Posts: 165
Weight Statistics 6/1/07 Start Date:
6/1/07 Surgery Date:
5' 6"
Height:
242 lb Start Weight:
150 lb Current Weight:
145 lb Goal Weight:
92 lb Weight Loss:
5 lb Lb Left to Lose:
38.0165289256 % % Lost:
12/31/08 Goal Date:
Body Mass Index 39.0555555556 BMI Start:
24.2079889807 BMI Current:
23.4010560147 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
I agree that is awful. i dont understand insurances, i heard in the long run it would be cost effective if you had the surgery than to take care of a person with a long history of medical issues that could be solved byweight loss surgery. Do you have any other opitions?
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07-13-2008, 05:03 AM
| #8 (permalink) |
| Guru In Training  Join Date: May 2008
Posts: 270
Weight Statistics 4/28/2008 Start Date:
12/1/2008 Surgery Date:
5' 6"
Height:
309 lb Start Weight:
264 lb Current Weight:
155 lb Goal Weight:
45 lb Weight Loss:
109 lb Lb Left to Lose:
14.5631067961 % % Lost:
12/31/09 Goal Date:
Body Mass Index 49.8684573003 BMI Start:
42.6060606061 BMI Current:
25.0149219467 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
That crazy! I have BS Cal Pers in Northern California, crazy that an employer can excudle certain surgeries or procedures.
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07-13-2008, 07:43 PM
| #9 (permalink) |
| Whipper Snapper Join Date: Jul 2008 Location: Brooklyn, NY
Posts: 18
Weight Statistics 7/12/2008 Start Date:
5' 5"
Height:
325 lb Start Weight:
323 lb Current Weight:
150 lb Goal Weight:
2 lb Weight Loss:
173 lb Lb Left to Lose:
0.615384615385 % % Lost:
Body Mass Index 54.0769230769 BMI Start:
53.7441420118 BMI Current:
24.9585798817 BMI Goal:
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Well, I don't have a traditional employer situation. I'm a freelancer in the television industry. My "employer" changes all the time, so it's thru my union. But totally lame. Not really too much ground to stand on. But it's ok, I'll self-finance and do payments. I had to get gallbladder surgery a couple years ago and the hospital worked with me on it. Knocked down a lot of the price, too. Maybe it'd be cheaper if I didn't go to one of the best places for it in the country (NYU, here in NYC). Sigh. It'll be all good. Thanks, folks 
__________________ Janice B Joined 7/12/08 Weight: 325 BMI: 51 |
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07-13-2008, 08:46 PM
| #10 (permalink) |
| Cub Reporter  Join Date: Jun 2008 Location: West Texas
Posts: 71
Weight Statistics 12/10/07 Start Date:
6/11/08 Surgery Date:
6' 5"
Height:
696 lb Start Weight:
460 lb Current Weight:
295 lb Goal Weight:
236 lb Weight Loss:
165 lb Lb Left to Lose:
33.908045977 % % Lost:
7/5/10 Goal Date:
Body Mass Index 82.5245403947 BMI Start:
54.5420812953 BMI Current:
34.9780738742 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass |
Yep the insurance company don't mind having policies with WLS included, it is up to the person for whom they are writing the policy. I work for the State of Texas and BCBS excludes it in our policy. In fact our state legislature has started talking about getting it written into it, even if premiums go up for those who want to choose that plan, which most people I feel would think that was fair. It is senseless that if it is now covered by medicaid, etc., that their should not be laws having it included in all insurance programs.
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