IMSKINNY

No, I don't mind at all, if you join in. Hey, you're lucky to have Aetna!! From what I've seen on this forum, Aetna is the best to have. I was told by my surgeon's office that my insurance follows the requirements of Aetna. I hope I get approved!! I, like you, have been heavy all my life. I've made up my mind too and wonder what took me so long. I have decided that if I am denied, I am going to find the money and self pay, if I have to. Whose your surgeon?

Wheetsin, that was super duper helpful info! My paperwork gets submitted after my last visit to my surgeon in June. I am startimg to get a little nervous....

Hey, I wanted to just check in on you and see how your process was coming along! I had an endoscopy last week! Yuck! It requires sedation. As a result, I was diagnosed with GERD. I thought I was kind of healthy until I started this journey.

I had the same question and finally just asked my NP at my surgeon's office. Mine did not require weightloss. Just ask.

Maybe getting the doctor to say that at the time, had the sleeve been a recommended procedure (as opposed to experimental), he would have recommended the sleeve rather than the band.

I know what you mean about what people say. One of my friends said today that she's hoping I don't have the surgery!! What kind of crap is that?! I don't think I'm a bad looking woman and I've always been fairly confident. I just think that she might be afraid that if I lose enough weight, I will REALLY be the bomb!! Either way, I've decided to stop discussing the issue with her. She's kinda getting on my nerves!!

It's sounds like your approval should be coming soon! I was told I had to do the 3 month supervised diet. The diet has been Meal Replacement shakes! This month I move to 2 shakes a day. Yuck! My last check in will be in June. I've had a gallbladder ultrasound, the psych eval, lab work, a sleep study, and the pre op EGD. My BMI is over 40 and I have hypertension, sleep apnea, and arthritis. The surgeon's office told me that the paperwork will be submitted to the insurer in June. Pray for me and I'll pray for you. Everyone goes to Covington for surgery. Which one are you using?

No, I haven't had the procedure yet. I have one more month of the supervised weightloss before the paperwork is submitted by my surgeon's office. I live in Alexandria and my doctor is in Lafayette. Where are you? Have you started the process yet?

I live in Louisiana, but I haven't heard of your insurer, but no one has heard of mine either.

Congratulations!

Hey, gang, I had a question! I was diagnosed with sleep apnea after using the home sleep delivery machine? Does that improve my chances of getting approved with a BMI of 40 plus and hypertension?

That's what the sleep people told me too, but she said my insurer never asked for the data download, which would reveal if I was using the machine. She thought that was odd, but maybe that means the insurer doesn't know what they're doing!

Wow! You guys have really scared me! I guess I will get the machine and try it. I have been very groggy in the AM over the last 2 years. The sleep apnea probably coincides with my weight moving past my comfortable weight level. I wonder if the insurer is thinking that they will pay for renting the machine for 6 months, rather than buying it, because they expect me to have the surgery shortly? I hope so!

I know that I am probably over thinking this, but here goes. I was told I have sleep apnea and my insurer has approved renting the machine for sleep apnea for six months. Did anybody not get the machine and still got approved?

I asked the NP at my surgeon's office that exact question. She said that I didn't have to lose a specific amount, but they highly discouraged gaining. I lost three at my last visit. But, I have gained that plus a couple since then. I go back next week and so, I'm going to do 2 shakes a day, drink lots of water, and exercise until next Wednesday. Yuck! Wish me luck!

I am sure the ins gurus on this message board will ask which ins you have.

Thanks folks for the information! I have some odd ins called CCMSI. They are a third party provider and one big beauracracy, if you ask me. I was told by my surgeon's office that my ins follows the same policy as Aetna, which, based on what I have read, is one of the better policies for this sort of thing. So, I think having sleep apnea helps because my BMI is over 40 and I take meds for hypertension. I go back for my 3rd meeting with the dietician and the NP on May 4. After that, I should only have one more visit, before the info is submitted to ins. Everybody take a deep breath .... AND PRAY!! Thanks.

Wow! 18 years out?! Had she kept the weight off? I'd be happy with a good ten years of weight loss! Ha! Well, we all deserve to do good things for ourselves! I'm a firm believer in that. I keep thinking I'll do this and think why didn't I do this at 35 rather than 45! Oh well... Better late than never! Yep, 7K is a lot of money, but it will be worth it. I really hope the ins approves it, but if not, I'm already thinking of plan b!

I probably should go to a support group. I've been feeling rather emotional about the decision to start this journey. I guess I want to make sure I'm approved before I do that. I've been talking to a friend a lot who is also considering WLS and to a friend who had it a year ago. He's lost 200 lbs!! He was over 400 when he started. What did they talk about in the group?

One of my niece's friends used it for her surgery. I don't know the details, but she loved it!

Is he in Houston?

Like you, I've been big most of my life. I've lost 40 or more lbs on my own, but it has always come back. I'm hoping this will be a jump start and I can then manage on my own. It'll be okay for both of us.

I have some odd insurance called CCMSI. I am a public employee and they are the third party administrator for my agency. The provider network is Verity Healthnet. WLS is excluded unless medically necessary, so I guess all of this is to prove I need the surgery. The EGD is a pre op test, but I think the sleep apnea test has been ordered because they think that I have it too. It's a home delivery test. The package came today. I put it on before bed and then send it back for them to read the results. Better than sleeping away from home.... I hope I get approved, then I will really start to worry.

Hey, and it seems like people with BCBS get approved quickly!