MelindaH

great news!

Hi all, Just thought I would let you know that the 2012 benefit book is on line at www.fepblue.org. It doesn't look like there are any benefit changes for WLS. They are however changing the pharmacy program. I have just scanned it but I thought you all might want to know. It is a relief to me as I am afraid I might have to wait until Jan but still hoping for Nov. Melinda

two thoughts call an insurance broker in the area and call his HR and see if they will tell you if they exclude WLS. Hopefully one of the two can give you some answers. Good luck, Melinda

I want to thank you for the post. I certainly do not judge you. Smoking anything is just not my thing....My son was addicted to it. I don't know how he has held down jobs but he has just about lost everything. It has been very hard on our family. My husband smoked occasionally for years but never missed a day of work. He had a feeling I didn't like it but I never did say anything. But the day we brought our daughter home, he said he would never smoke it again for me and for her. And he hasn't. Anyway, I wish you the best in your job. I hope they will work with you. I might add just one thing for others to see. At my Center of Excellence, they drug test and if you are positive for THC or anything else, it is a deal breaker. They do, however, make exceptions for chronic pain patients but you have to provide documentation. Melinda

My practice will not schedule until it is approved.

I am not losing weight fast enough. September and most of October have been a bust because of no exercise due to my back...long story... I know it will be Nov before I can take the required classes and I have to get down to the required weight before it will be sent to Blue Cross. With the holidays and all, I can envision not being able to get in in Dec. I am focused again on gentle exercise; yesterday, I rode the stationary bike for 20 minutes. Hope to do 30 tomorrow sometime.tomorrow. Glad you survived the manometry. Hope you get the results soon. Melinda

Did they give you a benefit book to read and compare BCBS is good insurance; however, each employer may have restictions etc on the policy. The name "Community Blue" makes me wonder if it is a managed care product. Check out each policy to make sure you know the weight loss surgery requirements. Good luck. Melinda

Hi, welcome to our forum. I am Melinda and I live down the road in Eugene. I am hopeful that I will have surgery in Dec. I am losing weight very slowly, partially due to medication that I am on. I have been unable to exercise for the last six weeks due to two herniated iscs with nerve impingement. I had two ESI's on Friday and hopefully that will do the trick. One of my goals of getting my weight off is simply take the weight off of my joints and my lumbar spine and maybe I would not have as much pain. There is more i could expound on but my eyes are seeing double. I just mainly wanted to welcome you and wish you all the best in your surgery and journey to good health. I hope you have a strong, local support system, too. Please drop in often and keep us abreast of your progress. Melinda

Congratulations.....good for you for being persistent and standing your ground. I wish you all the best for your surgery and in your journey to good health. And, also, I try to say this to every military person I come across on the forum. Many thanks to you, your husband and family for serving our country. If I already said it, just consider the source--middle age gray haired female, lol. Melinda

Thanks, I would be interested in what they say. Having billed insurance recently, this bothers me. We billed everybody, ins or no, the same charge. The reimbursement and co-pay is the patient's responsibility. I reported a pharmacy scam this summer on new drug I was prescribed. It was all together in one box and was being distributed as a new brand, just for the packaging, and I was charged over $100 for my copay alone. I realized that every drug that was a part of this was generic and could be bought separtately at a much cheaper price. They thanked me and said I was correct and appreciated my honesty. Melinda

That seems really over the top to me and I would report it to BCBS. I am thinking the cost for a fill averages about 250-$350 nationwide. It shouldn't matter if you have basic or standard....the charges should be the same, as is you should charge the same to pts with or without insurances. Please check this out. Melinda

As far as the diet requirement, there is probably no way to get around that. You may be able to appeal the decision to go out of state but there again, insurance companies pretty much call the shots. I think it is wrong but that is the reality and the new norm. The reason they want the supervised diet plan, I feel, is to make sure you are motivated to lose weight and can follow instructions. I wish you all the best but one argument would be the cost of gasoline these days. Keep us posted. Melinda

I talked to Blue Cross last week and they said off the cup that the benefit structure is not changing much. I am working hard to make it happen for me in Dec. Hope everything else gels for you. Let us know how your test goes. Melinda Remember all, open season starts around Nov 14th

Congratulations on your weight loss. I agree with BlackCadillac.....don't let anybody "rain on your parade". I am not a military wife and first off I want to say thank you to your and your husband for serving our country. I am very far away from my family but we are still in the US. I think long distance puts strain on relationships and friendships. I hope that your friend was just having a bad day......but I trust that you will educate her on how you have done it when it is appropriate. I am not a fan of facebook but I use it. I am from the old school of phone calls are made. You don't always know the feelings of the person who posts. I hope that this is not a break in a friendship but just a temporary time out. Keep up the good work. You are an inspiration to me. Melinda

Hi, and welcone to our forum. I think as long as you disclose everything up front with the doctor you will be ok. My psychologist would not clear me until she talked with both of my medical providers. They did talk and I was cleared. I am also Bip I. I have been on lamictal and it has made such a difference in my life. They will work with your med list and your primary care provider. It is important that you commit to regular visits with the surgeon and pcp after you have the surgery. All the best to you hon. Message me if you have further questions. Melinda

Congratulations on a job well done!

I do not know if you were referrrig to my post and if you were, I take no offense. Perhaps I should have elaborated. I had MRSA more than five years ago and am tested anytime I go in for surgery of any kind. They culture my nose for it. This is usuallly done during the pre-op workup. I have never tested positive since those two incidents but I have to agree to tested before any surgeries--as I will be with this one. I am also given IIV antibiotics pre-op once I am admitted to the surgery unit.

Not necessarily....I have had MRSA twice with knee replacements. The surgeon I saw is aware of it and did not seem concerned.....but it is up to your surgeon and criteria that may have to be met. All the best to you hon, Melinda

hon, be sure and check with your insurances. Most will not pay until your BMI is between 35 and 39. And then some require that you have two or more co-morbidities. I say, this not to discourage you at all. I would just hate for you to get into the process and then find out. I do not think you are crazy to want to lose weight this way at all but understand that it is a radical surgery and the surgery in itself will not change your life. You have to be willing and able to make the changes and you have to want to change and believe me I am saying that to myself as I write this. Just check with your insurance company....I assume you are on your parent's insurance but I could be wrong. You should be covered till you are 26 because of the Obama care. law. If you are self pay, it might be easier to get the surgery with your bmi, I don't know. At any rate, I wish you all the best in your journey to good health. Keep us posted of your progress. Melinda

Hi, welcome to the forum. I would urge you to call bcbs yourself and see. I would not take the insurance co-ordinator's word on your insurance. They deal with a lot of insurances day in and day out and you can get benefit structures easily mixed up. I used to verify insurance for a living. Also talk to their business office yourself. I wish you all the best in your journey to good health. Please keep us posted on your progress. Melinda

Hi and welcome, You are right....It is about you. I have told my immediate family (my husband and my children) but I have and will not tell my sisters who live out of state. I will tell them the next time I see them but only if they ask. It really isn't the " I would like to surprise them mentality" but the fact that I would never have their support for the surgery. They are the gut it up and do it type. My children understand that they are not to tell my sisters. Really other than them, I don't care who knows. I have al lot of support with my friends locally and out of town. I haven't had surgery yet but from what I have read, the jitteries are very normal for where you are at. I sincerely wish you all the best and I hope you will drop in with any questions and/or progress reports. Melinda

We do serve an awesome God, don't we? Congratulaitions on your decision and I know you won't regret it. Start moving a little bit and add a little bit each day. I have close ties to OK and tx but in the end I root for the Ducks and sooners, in that order, lol. Take good care and visit often. Melinda

If the employer excluded the coverage for this surgery, I don't think you have much of a leg to stand on. Do they mean appeal it to the employer to pay for the coverage for the surgery? Do you have a medical reimbursement plan?FYI, insurance "appeal" can be very long and drawn out. Wishing you all the best, Melinda

Oh, wow, would your primary care order it.......or a new gi? Anyone in his or her practice that will do them? Thinking of you, Keep your chin up....