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  642 People Lost in total 56561 lbs = 29.15 % Give us permission to add your before & after Weight Loss Photos |   |
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06-19-2007, 10:44 PM
| #1 (permalink) |
| Newbie Join Date: Jun 2007 Location: Waxahachie, TX (just south of Dallas)
Posts: 1
Weight Statistics 3/13/07 Start Date:
unknown at this time, waiting for insurance approval Surgery Date:
Height: 290 lb Start Weight:
280 lb Current Weight:
150 lb Goal Weight:
10 lb Weight Loss:
130 lb Lb Left to Lose:
3.44827586207 % % Lost:
June 2008 Goal Date:
Body Mass Index 45.42 BMI Start:
43.85 BMI Current:
25.06 BMI Goal:
 |  Newbie requesting any advise Hello everyone, My Name is Dinah, and I live near Dallas, TX. I have talked about and researched Gastric Bypass for years. My 1st consultation with a surgeon was 2/28/07. My insurance, Aetna, requires 90 days under diet supervision by a nutritionist or dr (or atleast that is what I am told by the insurance specialist at the surgeon's office). My last weigh-in and appointment with the nutritionist is Thursday, 6/21. I am very nervous. I've been peaking through the forums for any info to help me on my way. I have already sent in 7 or 8 years of doctor's charts proving I've been morbidly obese. I have done the psych evaluation, support group meeting, doctor's letter was sent in, and the initial nutritionist meeting. I am 31 yrs old, 5'7" and 280 lbs. I have been over weight my whole life, and obese for probably 10 years or more. I have tried everything over the years, and I had been pretty active until the last few years. I had pretty much given up any and all hope that I would ever loose weight. Sure, 10 or 20 lbs goes off kind easy, but never more than that... no matter how hard I tried. So.... after Thursday, it's a waiting game for the insurance to approve my surgery. I see posts of being denied, and it really worries me. I guess I'm trying hard not to get my hopes up, but I am just really ready. I hope it doesn't take a month and 1/2 like the doctor said it could. My best friend had the ruen-y in Februrary, and she wished she had had more time. I'm wishing I had less... nerves mostly. I've started to cut back majorly on my diet cokes, caffene, sugar, cigarettes, etc. I've also been trying to drink protein shakes as often as I can, usually 2 per day. How likely is the denial from the insurance company? Is it really that often? Should I contact the insurance company for the answer? If so, how long should I wait? I'm trying to quit smoking (I'm really not a heavy smoker now, maybe 3 or 4 cigarets a day), but the nerves just make me want to smoke more. Any advise would be appriciated. Thanks, Dinah Jean Last edited by dinahjean : 06-19-2007 at 10:58 PM. |
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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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06-19-2007, 10:54 PM
| #2 (permalink) |
| Seasoned Veteran  Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,369
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9" Height: 258 lb Start Weight:
151 lb Current Weight:
165 lb Goal Weight:
107 lb Weight Loss:
-14 lb Lb Left to Lose:
41.4728682171 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
22.2963663096 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass   | For starters welcome to the boards. I am not sure if you have seen this posted previously but you should contact your insurance company directly to find out if its even covered to begin with. You dont want to put yourself thru all of this only to find that the plan doesnt cover the surgery at all. We've seen that here before. Next, quit smoking now! I smoked almost two packs a day for 15 years. I quit right before my surgery and havent even thought about cigarettes since. Its hard to say how likely denials are. It depends mostly on your specific plan. Give them a call and see what they say. Good luck, and again welcome!
__________________ Anything worth having is worth working for Kenya R.  Lap RNY 4/19/07     |
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06-20-2007, 04:40 AM
| #3 (permalink) |
| Seasoned Veteran  Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,756
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  | ALSO would like to take a moment and welcome you to the boards. I am glad you found this site for all your support needs! ITS a great place to be around folks that understand. SOUNDS like your off to a wonderful beginning and we are here for all your Q's.....look forward to getting to know you thru your posts
__________________ LISA  http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass  |
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06-20-2007, 08:17 AM
| #4 (permalink) |
| Super Moderator  | Welcome to the board, thank you for joining us. Looks like you are off to a good start, good luck with your insurance. ((((((HUGS))))) May your journey go well.
__________________ "In every job that must be done, there is an element of fun."   Just a li'l bit 'bout myself  |
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06-20-2007, 08:27 AM
| #5 (permalink) |
| Big Loser Join Date: Mar 2007 Location: Raleigh, NC
Posts: 127
Weight Statistics 3/23/07 Start Date:
not yet waiting for date Surgery Date:
Height: 353 lb Start Weight:
270 lb Current Weight:
200 lb Goal Weight:
83 lb Weight Loss:
70 lb Lb Left to Lose:
23.5127478754 % % Lost:
12/31/09 Goal Date:
Body Mass Index 62 BMI Start:
62 BMI Current:
35 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Welcome to the board! You are off the a good start! I will also say it is time to quite smoking. A lot of doctors won't do surgery unless they have you nitotine free of a month or so. I would check with yours. I would also go ahead and start walking if you can. Anything helps. Even if it is just a block a day. One block a day will lead to two block the next week ect..... It will help in recovery. Thats what they tell me anyway, I have not had my surgery yet, I am waiting on insurance approval as well. Good luck, don't let it stress you out too much. There is always an appeal to be done. Most insurance companies are coming around now a days. Good luck
__________________ ANNA  |
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06-20-2007, 10:16 AM
| #6 (permalink) |
| WLS Master Guru  Join Date: Mar 2007 Location: Louisiana
Posts: 899
Weight Statistics 4/23/07 Surgery Date:
Height: 385 lb Start Weight:
257 lb Current Weight:
190 lb Goal Weight:
128 lb Weight Loss:
67 lb Lb Left to Lose:
33.2467532468 % % Lost:
Body Mass Index 62 BMI Start:
41 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass | Welcome to the board, I think you are heading in the right direction. Roz
__________________ Too Blessed to be Stressed  |
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06-20-2007, 08:55 PM
| #7 (permalink) |
| Seasoned Veteran  Join Date: Mar 2007 Location: Floyd County Virginia
Posts: 3,591
Blog Entries: 1 Weight Statistics September 19th 2007 Start Date:
September 19th 2007 Surgery Date:
5' 10" Height: 363 lb Start Weight:
211 lb Current Weight:
165 lb Goal Weight:
152 lb Weight Loss:
46 lb Lb Left to Lose:
41.8732782369 % % Lost:
12/31/09 Goal Date:
Body Mass Index 52.0793877551 BMI Start:
30.2720408163 BMI Current:
23.6724489796 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Hi DianhJean. Im Vickie and welcome to the boards. Im glad you found us. As for your insurance...... It all depends on what plan you have and the criteria you have to meet. If you meet each thing they ask you then they have no reason to deny it. But sometimes they do. My advise is always this: Call the number on your insurance card. Ask if YOUR plan they find that buy the group number on the card.. pays for Weight Loss Surgery. If they say yes then ask them what criteria has to be met. Make sure you write this all down. Including the person name. Then you will have it right in front of you with no surprises. Some are very strict some are not. I will say your the first Aetna I have seen but I have only been on this board since March so I will be watching how yours does closely. Some on here have waited a long time. Some have went to the Dr and got a surgery date within a month. Most of the time the normal amount of time is about 3 months from start to finish. Good luck on this..... Im kinda insurance savy sometimes so don't hesitate to ask questions. |
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06-20-2007, 10:45 PM
| #8 (permalink) |
| Big Loser  Join Date: Aug 2006 Location: Snowy Colorado
Posts: 171
Weight Statistics 11/13/06 Start Date:
3/27/2007 Surgery Date:
Height: 227 lb Start Weight:
165 lb Current Weight:
127 lb Goal Weight:
62 lb Weight Loss:
38 lb Lb Left to Lose:
27.3127753304 % % Lost:
before I am 60 (3 1/2 yrs) Goal Date:
Weight Loss Method Roux en Y Gastric Bypass |  Nice to meet you. Insurance is a funny thing. I work with it and see things that make absolutely no sense whatsoever. Just trust your doctor and play the waiting game. Meanwhile, arm yourself with all the infoyou can get. I started these boards 6 months before my surgery and have a wealth of information at my fingertips on this site. Enjoy the info and ask, ask, ask any and all questions to anyone...we all love to share or experiences. Good Luck to you and welcome.
__________________ colosn0w aka Donna   |
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06-21-2007, 08:19 AM
| #9 (permalink) |
| WLS Mentor  Join Date: Aug 2006 Location: Milford Kansas
Posts: 1,205
Weight Statistics 09/01/2006 Start Date:
5' 4" Height: 254 lb Start Weight:
144 lb Current Weight:
140 lb Goal Weight:
110 lb Weight Loss:
4 lb Lb Left to Lose:
43.3070866142 % % Lost:
02/01/2008 Goal Date:
Body Mass Index 43.5942382812 BMI Start:
24.71484375 BMI Current:
24.0283203125 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Welcome and good luck on your journey. |
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06-21-2007, 02:23 PM
| #10 (permalink) |
| Seasoned Veteran  Join Date: Mar 2007 Location: Texas
Posts: 1,558
Weight Statistics 3-16-2007 Start Date:
July 23, 2007 Surgery Date:
5' 7" Height: 284 lb Start Weight:
178 lb Current Weight:
160 lb Goal Weight:
106 lb Weight Loss:
18 lb Lb Left to Lose:
37.323943662 % % Lost:
7-23-08 Goal Date:
Body Mass Index 44.4758298062 BMI Start:
27.8756961461 BMI Current:
25.0568055246 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | Welcome and good luck. I didn't get a denial from my insurance company. I did call them before I went to see the surgeon. They told me that he had patients approved before and that he would know what critera needed to be meet. Apparently he did, because I got approval the first time around. So, it isn't always a fight to get approval.
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