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Everything posted by milkD
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I'm thankful my surgeon doesn't even book the surgery date till after you pass all the tests. I would be really upset too if my date was moved. I wish you guys best of luck! PS. I'm surprised some people don't have to do EGD. Mine was vital because of acid reflux. Apparently if there is too much damage in the throat from reflux the sleeve is not an option.
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Just Decided To Have The Sleeve Done...where The Heck Do I Go From Here? Help!
milkD replied to kcarroll's topic in Tell Your Weight Loss Surgery Story
The easist way to break it down is you can think of surgeries like this has having three phases. 1) Deductible phase - this is where you are responsible for 100% of the allowed amount charges approved by the insurance company. 2) Co-insurance phase - this is where the insurance company helps to foot some of the bill in your case 80% of it. Most insurance companies have a co-insurance cap and after that's met... 3) Out-of-Pocket Max Phase - this is where you have satisifyed your out of pocket maximum which consists of your deductible cap and your co-insurance cap combined. Once this is achieved your insurance will begin to process at 100% of the allowed amount for the remainder of your benefit year. So what you'll want to do is when you speak to your insurance company make sure they clarify co-insurance maximum vs. their out of pocket maximum (even insurance carriers often get this confused in their verbage when quoting benefits). Here's a basic scenario to explain. Let's say you go and have a surgery and all your bills combined comes out to $22,000.00 You're benefits for insurance include a $2000.00 deductible, a co-insurance of 80/20% with a co-insurance maximum of $2000.00 - that means your out of pocket maximum would be $4000.00. So 22,000.00 minus the $2000.00 deductible leaves us with $20,000.00 20% (your responsibility of the co-insurance) leaves you oweing $4,000.00 of the $20,000.00 - BUT because we have a $2,000.00 co-insurance maximum you only pay that $2,000.00 and the insurance picks up the other $2,000.00 that would of been part of your 20%. So your out-of-pocket maximum has been met totalling $4,000.00 of the $22,000.00 bill - even if that bill was 40,000.00 you'd still only pay the $4,000.00 for in-network services rendered. Sorry for the long explination - it just really helps I think to understand how it all works at the insurance company (they definatly don't make it easy to understand up front lol). I know I wouldn't understand it if it wasn't for my loving, awesome, supportive husband who's super cool. -
Thank you Cheri! That was incredibly helpful information. I'm very excited for food to become 'uninteresting' and become a back seat for me. This board has really helped with learning to be patient however and it will all take time. I wrote down Syntrax and will have to try it. Do you drink a shake daily as a Meal Replacement or in addition to your three meals? Just curious if it's an easier solution thing or just because you need the extra protein in your diet.
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Thank you great idea!
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Just Decided To Have The Sleeve Done...where The Heck Do I Go From Here? Help!
milkD replied to kcarroll's topic in Tell Your Weight Loss Surgery Story
Hello! Some notes about insurance as I am lucky enough to have a husband who's worked as an insurance specialist. Not only should the doctor you find be in-network but also make sure the hospital and anesthesiologist are covered. If they are in-network then your insurance (as you stated) will cover 80% of it. The first doctor I found was in-network, however the hospital was not so it wasn't an option. Your insurance should also have something called a maximum out-of-pocket. This means there is a maximum amount that you have to pay each calendar year for medical services. This amount on average will be $1,500-$5,000. If yours is $2,500 for example... EVEN if your surgery costs $100,000, 80% would be $20,000 left for you, you would still only pay a maximum of $2,500. I doubt you couldn't finance this cost into monthly payments either. I'm still paying off mine from a year and a half ago for having a baby! So really there should be no concern abou the actual cost of the surgery as long as the doctor, hospital and anesthesiologist are covered. Please also note that there will be additional testing you'll have to do. Most of this should be covered as well. However my insurance didn't cover the psychological evaluation I had to have. If you're in the same boat you can always find a cheaper psychologist. It took me about 6 months from the time I initially called to make my first appointment to my surgery date in the end of July. Two of these months were just waiting for the first appointment as my doctor is busy so yours may be faster. -
Congrats for you. I hope for only the best. My surgery is on the 24th too
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Looking For Low Carb Recipe/suggestions Puree Phase
milkD replied to vsjb's topic in Post-op Diets and Questions
So I had always thought that mashed potatoes, one of my favorite things to eat, would have to be cut out because potatoes contain a lot of carbs. But I'm seeing a lot of people on here mentioning they eat it. Was I wrong all along? -
Just Got Surgery Date Of July 25Th!
milkD replied to Jlewis229's topic in PRE-Operation Weight Loss Surgery Q&A
I'm a day before you. July 24th!!! I'm so excited, this date cannot get here fast enough. I had to pass all my medical tests before I got a date. Blood tests, x-ray, ekg and upper endoscopy. I also had to do a stress test because my ekg was slightly abnormal. The Upper Endoscopy was more than I thought it would be. It's a minor surgery with gowns and IVs and operation rooms and everything. At least mine was. It wasn't bad at all but you have to take a day off work. -
Making Progress With The Red Tape
milkD replied to olivia1425's topic in Tell Your Weight Loss Surgery Story
Good luck I was told it would take about 4 weeks for my insurance to approve the surgery but it only took them one week!! Maybe you'll have luck too. -
Getting Ready For A New Beginning
milkD replied to EcuaTrucho's topic in Tell Your Weight Loss Surgery Story
Hey Carlos. I'm also in the San Jose area but getting my sleeve done at Stanford last week of July. I think you're doing an amazing job and you sound like a wonderful father. Don't worry, next week is July already and August will be here before you know it. I can relate to your story as my husband is also a stay at home dad to our 19-month son. He too is overweight though his BMI is not as bad as mine. He's decided to follow me though and eat what I do (just slightly more) including the 2-week liquid diet. I'm excited for both of us. Keep us updated and best of luck to you. -
Honesty Vs. Lying About The Surgery
milkD replied to Lovely's topic in PRE-Operation Weight Loss Surgery Q&A
Like a lot of people, my weight issue is uncomfortable and embarrassing to me. My husband, parents, brother, MIL know but I have no plans to tell anyone else. I have close friends at work but all my best friends are across the coast. I have taken off time at work and will tell anyone who asks that I am just enjoying a much needed summer vacation where family is coming to visit and my brother is expecting his baby (which is all true). If anyone asks about my condition right after returning to work I will just mention my stomach has been bugging me. I've already started dieting (eating low carb/fat). I don't have a problem mentioning this fact at work that I'm trying to eat healthier and exercise more. I'll be doing the liquid diet pre-op for 2 weeks so with all this factored I don't think my behavior post-op will seem as strange. I know this sounds harsh but this is what I feel most comfortable about. If anyone compliments me, I will say "thank you very much". If they ask me how I did it I will say "I finally chose to eat healthier. Cut out fats and carbs. I'm exercising a lot". This won't be a lie becaue the surgery is a tool and it is not the surgery ALONE that will get me to my goal. Though I do believe if anyone asks me outright about having surgery I may admit it. Not mentioning a fact is one thing, but outright lying is another. Perhaps after some weight loss and a much happier me I will feel comfortable telling my best friends but for now this is my plan . -
Anyone Else Have A Surgery Date In July? Excited And Terrified!
milkD replied to chromerose's topic in Gastric Sleeve Surgery Forums
Surgery is on July 24th. I cannot wait any longer. I have one more lecture/group session on the 3rd and then preop with the surgeon and nutritionist on the 12th. Hurry up and be end of July already.