mufasas-mom

good luck - i'm sure the insurance company will be able to direct you to a good surgeon in your area. I hope the place sends you all the medical records.....that is so awful about that 1-800 place....

I'd call your insurance company and get the EXACT qualifications yourself - not the doctor's office - then go to your insurance company's website and search for the doctor's which ARE in your network - get all the documentation and paperwork from the place you just spent 8 months with - and bring it to a new doctor's office that's in your network. i cannot stress enough how it's the PATIENTS RESPONSIBILITY to obtain all the insurance requirements and be on top of things - this is a very important step you are taking for your health - why would you leave that up to some morons in a doctors office.... let us know what your insurance company says.....you may have been denied in the beginning from something simple like missing paperwork - you must call and speak to your insurance company rep. - look on the back of your insurance card.....

SAM017 - it doesn't matter where you live - it's all about your employer and what bariatric options they selected for your insurance benefits. Nobody on these forums can answer your questions with 100% accuracy unless they have the same insurance plan and work at the same company. general rule for most insurance companies is BMI over 40 or BMI under 40 with 1 or 2 co-morbidities (ie diabetes, hypertension, etc). the only way to get answers is to call the phone number on the back of your insurance card and ask about bariatric surgery coverage, then ask about requirements.

put that money aside for your new wardrobe!!!

I have UHC Choice Plus program and had to do the 6 month diet. it's good, as you get time to really think about the surgery and how it will affect you for the rest of your life - it gives you time to do your homework, to work on eating slower and work on any eating issues you may have. I already cut my food in half automatically - and I am quite satisfied with that. Already been logging all my food into myfitnesspal - and keeping at 1200 a day or lower. My last appointment is Aug. 1 - then we submit to UHC and set the surgery date..... I was happy to have the 6 months - it gave me time to really learn about this tool - it went by pretty quickly too..... good luck.

call the insurance company - not your doctor's office - ask if they use the starting weight/bmi or the ending weight/bmi. I double checked this with my insurance and luckily they use the beginning weight/bmi. every time i go onto the true results office for weigh in and such - i've lost a few pounds - they just say - we'll put it at 197 to be safe. don't take anyone's word for it at your dr's office - there are WAY too many insurance policies out there and tons of variations of each policy....double check it yourself!!

lucky you....I have UHC and still have to do the 6 month - but 5th appt is on July 2, then August 3rd is last appointment and i think i see the surgeon then - then it's the waiting game while they send all the data to UHC for approval (I've already contacted the bariatric group within my insurance program so I'm all set there). So I am hoping to have the surgery late August or early Sept. Would love to drop 30 pounds by the time the holidays roll around - maybe I'll even allow my picture to be taken...ha ha.

my Ah Ha moment was over the christmas holidays last year - when I realized that it was very difficult for me to get up and down when playing with 1 yr old granddaughter and then seeing the pictures my daughter was taking with her new camera....I remember saying - geez this new camera adds 30 pounds to me...then realizing finally that size 16 was so NOT cool for someone who is 4'11"...so I started investigating options - I was hoping to have this surgery done by the time I turned 50 this year...but 6 months of stuff for insurance...hope to be banded in late August or early Sept - hopefully in time to drop around 30 pounds by this years christmas holiday and have no more FAT FACE....

For all, please remember that it is your sole responsibility to follow up with your insurance company to ensure that all requirements are being met in order for the surgery to be covered. I had my 4th appointment on May 30 (dietician) and May 31 (psych eval which was pretty fun). True Results receptionist made my next appointment (5th appt.) for July 2, I informed her that I needed to be seen each month and not to skip a month - she said my insurance required that i wait 30 days inbetween appointments. So i called my insurance company, and this is horse crap - If i didn't call the insurance company - I would of had to start all over with the 6 months again, and then I'd be looking at next year and having to pay all the out of pocket costs involved (as i've reached Max out of pocket and ded for this year -so all is covered at 100%). i just accepted the appointment and did my own homework - word of caution - I know that they (True Results) are a money making profit center - but this could of cost me dearly had I not stayed on top of things. the receptionist was so freaking rude - as I was driving to my psych eval I got a phone call right as i stepped into the elevator - it was 12:01PM and my appt. was 12:00 - WOW one freaking minute late and they start calling to make sure I'm still coming - as i said before the receptionist was so rude - you would of thought i was 15 min late or so....but they make me wait 10+ min every time....and I'm the 1st appointment of the day each time - I am there by 7AM (so i don't have to miss so much work time) or earlier. I'm sure the surgeon is fine and such - it's the staff there that piss me off....actually it's the front desk staff - the nurses and such have been great. Please DO NOT EVER trust the doctors office or surgery centers to fully know your insurance - that's your job!

wow - carb intake at 125 is great - I'm diabetic and my docs say my carb allowance per day is 165- which I don't hit everyday - but I've learned to cut every meal in half and make it two meals - our office offers meals to go -so around 4:00pm I run down to the cafeteria and grab a meal (usually salad with grilled chicken and such) but they are HUGE salads and nobody should really finish a whole one....as i'm sure it's like 3 portions.

Lucky you - you must have good insurance as to not have to do the stupid 6 month supervised diet.... Congrats on your new surgery date....

cool - i'll have to check it out....thanks.

does anyone know of a good (preferably free) app that tracks stuff for diabetics? i have fitness pal already - but not sure that is enough.... would love to find a program that put in what my fat/carb/sugars/ should be for each day - and track that way.... if there is not one - i can still use the fitness pal and just have watch it closely..... secondly - anyone here with diabetes that can share tips or point me in the direction of a good cookbook or diabetes 'bible'? thanks

well the phone call last week from the carewise nurse with united healthcare was correct...I do have diabetes. Will visit with my doctor tomorrow to find out what I need to do....my lab results were awful....my cholesterol is so high 250 (norm 100-199)...A1c was at 6.5 (norm 4.8 to 5.6)- and glucose, serum - was at 138 (norm 65-99). I am so freaking pissed off at myself for letting me get here,....it's nobody's fault but my own for eating like a little piggy. I've always been a size 6-8 for all my adult life and then I started working here at PepsiCo and I put on 70 pounds in 4 years....I'm so irritated. I hope they don't put me on lots of meds.... Just left a voicemail with my bariatric nurse at united healthcare to see if now that I have 2 co-morbidities and BMI over 40 - do i still have to wait the 6 months??? would be nice to be able to move the insurance timeframe up a notch!!

Just spoke with my bariatric nurse with united healthcare and I MUST do the 6 months supervised diet - that's ok, cause next week is my 4th visit - w/psych eval and such - so 2 more months will fly by and it gives me a chance to learn how to eat better prior. only thing is I also have Chron's and with that I cannot eat raw veggies (plus I have stupid dentures from years of chemo that destroyed my teeth, so with dentures it's impossible for me to chomp on veggies and fruit like apples - I have to buy the freeze dried apples). So my diet will have to consist of fruits i know I can eat and cutting out ALL of the bad starches/carbs.

thanks for the feedback. I will mention it to my surgeon, although i think i'll try the band first, as having my stomach removed is pretty freaking scary to me... looking foward to talking to my primary care doctor today about the diabetes, as now alot of things are clearer - why i'm always tired, why i go to the bathroom constantly, maybe why i have these 'dizzy spells' although i'm not sure what to call them as i have them about 3-5 times a week usually between 4:30-5:30pm on my drive home from work, i get the very quick onset of dizziness and feel faint - then it passes within 30-60 seconds. so maybe that's my blood sugar falling or rising or something... my son came over last night to go grocery shopping in my pantry...can't believe how much I thought some of the healthy choices i was making were really bad...like Nutri Grain bars - full of sugar and carbs. have to go grocery shopping all over again....

baby foods...didn't even think of that for my 'mushie' stage - I'm not banded yet - but scoping out the posts getting ideas...and since I live alone and don't cook for anyone else - maybe eating baby foods will be more convenient....

seriously - i had no idea that the banded section was smaller that a pill??? wow....that's tiny. its amazing any food get through that....

swallowing pills is easy for me and i'm sure the 'pouch' it wider than a pill....so i can's imagine having problems taking vitamins or medications as long as I take them prior to a meal....so they go down safely and not sitting on top of food...at least that sounds logical to me - but what do I know - I'm not banded yet....

has anyone tried the One A Day Women's Petite Vitamins?? they are 1/2 the size of regular vitamins - hoping they are small enough - buying some today. can't tolerate the chewables or gummy vitamins...

OK - just checked my online account with UHC and I have already hit my deductive and already met my out of pocket maximum of $2500 - so my question is - when i get the lapband is all i'm required to pay for is the 20% (ins. 80%)? or nothing since I've hit my maximum out of pocket already?? not clear on how that all works.....

Each plan is SO different - I went through all this already, although True Results wouldn't give me a written estimate...which still pisses me off - I hate financial surprises..... I love surprises in general, but not those that cost me money!! But I am lucky and discovered that not only have I met my deductible, but have also already reached my Max Out of Pocket for the year...which means everything is covered at 100% for the rest of the year!! YES - I already confirmed this with the insurance company, as i have no co-pays. take care and good luck! I have to wait till August to be banded....

only way to know for sure if to either call Aetna - plus the doctors office who is giving you the estimate - may not have your recent Aetna statement that shows what you have paid to date. Personally - I went to my companies intranet and logged onto our insurance - printed out what has been met already (deductible and out of pocket) - so there is NO confusion when i visit the surgeon's office closer it gets to surgery. You have to do these things yourself to make 100% sure.

is it the surgeons choice where to put the band, or can you request it to be next to the belly button? or even lower?? can it be seen once you lose the weight and in swimsuits again??

good luck - keep us posted!! I'm sure you will do great!