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Old 01-23-2007, 01:11 PM   #1 (permalink)
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Join Date: Jan 2007
Location: Miami FL
Posts: 84

Weight Statistics

1/15/07
Start Date:
Height:
304 lb
Start Weight:
287 lb
Current Weight:
140 lb
Goal Weight:
17 lb
Weight Loss:
147 lb
Lb Left to Lose:
5.59210526316 %
% Lost:
12/31/07
Goal Date:
Send a message via MSN to leyva29
Unhappy Gastric Bypass Surgery and Avmed Insurance of South Florida

Hi, my name is Andrea and I'm 39 years of age. I was thin all my life until I reached my late 20's, I started gaining weight slowly. I kept doing crash diets and I would lose a good amount of weight. By my early 30's I decided to go to a doctor and lost about 80 lbs. My health was back to normal and I was still young enough to keep it off. I'm the kind of person that if I commit myself to lose the lbs. on my own, that I was able to come back to a normal life. I met my husband when I was 32 and didn't get married until I was 34. My metabolism began to change and I started gaining the weight back.
I'm weighing 304 lbs. right now and my BMI is of 49.1. My PCP spoke to me about the Gastric Bypass Surgery and recommended me to have it done soon. Not only he recommended me to have the bypass but I have no children of my own and my husband and I would like to have at least 1 child. I have many factors going against me right now such as diabetes, high blood preasure, sleep apnea, poor circulation and breathing problems. I have mood swings at time and I'm afraid it may affect my relationship if I don't do something about it. My husband supports my decision and is helping me cope with my bad health.

I have great doctors and my ob/gyn is working along with my pcp and so forth. I've made appointments with a Gastric Bypass surgeon for a group session and a pulmonologist to treat my sleep apnea. My sister-in-law told me that the only one factor that is working for me is that I have a good heart. I had an ekg done and my heart is good. My sister-in-law is an ICU nurse and she tells me to do it while my heart is in good condition. Well, I've been talking to people that have done it and I decided to go ahead with the surgery.

Is the PCP doctor the one that suppost to submit paper works to my health insurance? I have Avmed health insurance of South Florida. I'm wondering if my insurance will cover? I'm a bit nervous about the Insurance part may not be able to cover it. I have an appointment with the surgeon this week for a group session he's having this week. This will help me alot. But, I'm wondering if AVMED would cover it for me. Anyone knows of AVMED of South Florida.

Please advice!

Thanks in advance. Andrea.

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Last edited by leyva29; 01-23-2007 at 01:20 PM.
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Alt Weight Loss Surgery Insurance
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.

   
Old 01-23-2007, 01:35 PM   #2 (permalink)
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Join Date: Jan 2007
Location: Cuero, South Texas
Posts: 529

Weight Statistics

May 1, 2007
Start Date:
June 25, 2007
Surgery Date:
5' 4"
Height:
280 lb
Start Weight:
167 lb
Current Weight:
130 lb
Goal Weight:
113 lb
Weight Loss:
37 lb
Lb Left to Lose:
40.3571428571 %
% Lost:
December 25, 2009
Goal Date:

Body Mass Index
48.056640625
BMI Start:
28.6623535156
BMI Current:
22.3120117188
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default Welcome

Andrea, Wlecome to the board. Don't know much about avmed. I am in Texas and I have Tricare (military) insurance. So far no problem, but they would not cover the lapband. I am still waiting on my scheduled date. Should be in about 4-6 weeks. Good Luck and I think this will turn your life around. This site is very helpful and and supportive. Mattie
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Old 01-23-2007, 01:42 PM   #3 (permalink)
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Join Date: Jan 2006
Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,808

Weight Statistics

June 1, 2005
Start Date:
5' 5"
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
51.5810650888
BMI Start:
27.7872189349
BMI Current:
26.4560946746
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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Default

HI ANDREA!
i tried to reply and had a big computer hiccup so let me try again!
FIRST off welcome to the forums you found a great place to come with questions and get support on this great journey your beginning.

MY paperwork was submitted to my insurance company by my surgeon but after i had gotten clearances from a cardiologist, pulmonary specialist, had an upper endoscopy, saw a nutritionist, had a pscy. evaluation , a gall bladder songram and had blood work done. I also had to have my PCP write a letter recommending i have the surgyery as well for the surgeons submittal package to insurance company. NOT all plans cover weight loss surgery each plan is unique. IF you go should run into some insurance issues...i would suggest you get he ebook this site offers for taking on the insurance company and winning.

MY approval went fast. EVERY insurance company is different in response times. I was very pleased with mine.
GOOD LUCK!!! and feel free to ask away everyone here loves to help and
offer great support
HUGS and welcome
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LAP RNY Gastric Bypass

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Old 01-26-2007, 06:07 PM   #4 (permalink)
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Join Date: Jan 2007
Location: Miami FL
Posts: 84

Weight Statistics

1/15/07
Start Date:
Height:
304 lb
Start Weight:
287 lb
Current Weight:
140 lb
Goal Weight:
17 lb
Weight Loss:
147 lb
Lb Left to Lose:
5.59210526316 %
% Lost:
12/31/07
Goal Date:
Send a message via MSN to leyva29
Default

Thank you Mattie for the support. I know things will be okay for you as well as for me. My PCP doctor recommended that I go to a group session to a nearby hospital by my home to learn more about the Gastric Bypass Surgery, the pros/cons and also to hear comments from patients that have gone through the surgery. I think it will help me understand better what will happen to me after the surgery. I've been researching and talking to people as well. I'm going to keep my mind positive and accept what comes my way but I will not give up.

As I've read from this forum, I know people like you and me are put on hold for a short time but we will make life better and learn from it too.

Keep me posted about your health. Wishing you good health and strength. Good luck in your surgery. Andrea
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"Sometimes the smallest decisions can change your life for ever".





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Old 01-26-2007, 06:09 PM   #5 (permalink)
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Join Date: Jan 2007
Location: Miami FL
Posts: 84

Weight Statistics

1/15/07
Start Date:
Height:
304 lb
Start Weight:
287 lb
Current Weight:
140 lb
Goal Weight:
17 lb
Weight Loss:
147 lb
Lb Left to Lose:
5.59210526316 %
% Lost:
12/31/07
Goal Date:
Send a message via MSN to leyva29
Default

Lisa thank you for answering back to me. I'm learning so many things about the Gastric Bypass Surgery. I've researched through the internet. I've spoken to people that have done the surgery in short/long term and they tell me it's worth the pain. I'm going to a group session that my surgeon is instructing to new patients and he's invited me to attend the lecture so that I know the procedures and the pros/cons of the surgery.

I'm not so sure about my insurance but I'm hoping to God that I can do the same thing as you did. Have my doctor send letters to my insurance company to help me get the approval. I have alot of health issues to deal with. I have sleep apnea, diabetes, poor circulation, no menstruation at this moment, and problems with my breathing. I think I mentioned it before I weight 304 lbs and my BMI is 49.1 right now. I'm taking medications for my diabetes and for my blood pressure. About a week ago I had my 5th biopsy done in the Uterus because my cells were growing and the doctor didn't want me to become 1 in a million to get pre-cancerous cells. So, I have to take medication too so my menstruation comes down. Over all I feel that I really need to do what my doctors think I what's best for me. But, what has me preocupied is my insurance. I guess I will have to get the ebook your telling me.

Anyways, my doctor will have to send a letter to my insurace company and try to determinate what will come out of this mess I'm in now. You look really good and thank you for your support. I really appreciate it and will keep you posted. As soon as I finish the group session on Thursday I will let you know how it went. Andrea
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"Sometimes the smallest decisions can change your life for ever".





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Old 01-26-2007, 06:12 PM   #6 (permalink)
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Join Date: Jan 2007
Location: Miami FL
Posts: 84

Weight Statistics

1/15/07
Start Date:
Height:
304 lb
Start Weight:
287 lb
Current Weight:
140 lb
Goal Weight:
17 lb
Weight Loss:
147 lb
Lb Left to Lose:
5.59210526316 %
% Lost:
12/31/07
Goal Date:
Send a message via MSN to leyva29
Default

I went to the Gastric Bypass Session that my surgeon was lecturing yesterday and have my first appointment with him on March 6. I can't believe I'm making my first step already.

But, I know this is just the beginning of a new journey for me.
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"Sometimes the smallest decisions can change your life for ever".





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Old 01-26-2007, 11:20 PM   #7 (permalink)
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5' 5"
Height:
Default

Congratulations on your first step forward!
Please keep us posted on our progress.
(((((((HUGS)))))))
__________________
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So long as you are putting your best foot forward, then,
PATIENCE and PERSEVERANCE
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Old 01-29-2007, 05:19 PM   #8 (permalink)
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Join Date: Jan 2007
Location: Miami FL
Posts: 84

Weight Statistics

1/15/07
Start Date:
Height:
304 lb
Start Weight:
287 lb
Current Weight:
140 lb
Goal Weight:
17 lb
Weight Loss:
147 lb
Lb Left to Lose:
5.59210526316 %
% Lost:
12/31/07
Goal Date:
Send a message via MSN to leyva29
Default

Thank you Dr. DocSanae. I will let you know any updates. The only problem I think I will have is that my insurance does not cover the surgery. HELP!
I'm keeping my fingers crossed. And, pray to God to help me.
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"Sometimes the smallest decisions can change your life for ever".





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Old 01-29-2007, 05:31 PM   #9 (permalink)
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Join Date: Jan 2006
Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,808

Weight Statistics

June 1, 2005
Start Date:
5' 5"
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
51.5810650888
BMI Start:
27.7872189349
BMI Current:
26.4560946746
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
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got my fingers crossed for u too!
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Old 01-29-2007, 05:57 PM   #10 (permalink)
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Join Date: Jan 2007
Location: Miami FL
Posts: 84

Weight Statistics

1/15/07
Start Date:
Height:
304 lb
Start Weight:
287 lb
Current Weight:
140 lb
Goal Weight:
17 lb
Weight Loss:
147 lb
Lb Left to Lose:
5.59210526316 %
% Lost:
12/31/07
Goal Date:
Send a message via MSN to leyva29
Default

Thank you Lisa. I'm a bit nervous about this whole thing with the surgery but I'm keeping my head high. Best of luck to all of us looking for help.
__________________
Andrea Leyva
"Sometimes the smallest decisions can change your life for ever".





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