Raven21

Where in MI did you go?

Yes, it's for sure less if you are self pay. I was told $16k if pre-op stuff got covered by ins. $19k if not.

I'm hysterical right now. I've got my final PCP visit this afternoon so I called my surgeon's office to find out what documentation they needed from her. Day 90 of this 3 month program is November 15th so I want to make sure everything is in order long before then. My last nutrition and psych/behavioral appts are next Monday. She said the notes from the visits. I asked about the 2 year weight history. I remember reading that I needed documentation that I've been fat for at least 2 years. She said oh yes, notes from 2010 and 2011 also. I said I didn't think there was a note from 2011, but lots from 2010, 2009, 2008, etc. Nope. They will reject it unless it's the previous 2 years. Which would mean I couldn't have the surgery until 2014. And all this hope and planning and appts I've been going to since the end of July are all in in the dust at my feet. I'm so nauseous and dizzy I can barely breathe. Obviously I need to verify dates at my appt today, but in my gut I know there's no 2011 weight. I had given up for most of 2010 and all of 2011. I wouldn't even step on a scale.

No other insurance choice for me. Just Aetna. Find out now or you may have to repeat the 6 months. I can't believe I'm just learning this now.

Damn, where'd your butt go?! Looks fantastic!

I was told by Aetna that they are required to respond within 7-14 days.

I'm still in shock over your amazing response time. If you don't mind me asking, did you have a BMI over 40 or did you have to document comorbidities?

Response in 24 hours? Seriously? I'm on the 3 month track too. 90 days will be November 15th.

On the phone, Aetna told me they are required to respond within 7-14 days, but it looks like some people get theirs sooner. Me, I hope! And you too!

I'm hoping to have all my boxes checked by November 15th for submission. The Bariatric center I'm using said they have only ever had one Aetna denial and it was because there were no doc notes to prove at least a 2 year history of obesity.

Damn! Where'd your butt go? Congrats!

Yay! Did you get a date yet?

I keep going back and forth on this. I know it's still a part of me but I feel as though it is a very special gift that I have to take very good care of and nurture correctly. Which I did not do the first time around in life. So maybe I do need a name. Whoever she is, I can't wait to meet her, hopefully in December! Maybe Precious.

Let's hear 5 purely positive things you are looking forward to doing/trying. Things that will reward you for all your weight loss struggles that you will have finally overcome. Things like - "going sledding with my kids." NOT - "Not having to watch my kids go sledding without me because I'm too fat." Get it? Here are mine: Going on a long overdue trip to Vegas with my husband. Having sex, with him on top. Riding bikes with my kids, if they can keep up with me! Spending too much money on clothes because everything looks great on me, even light colors! Buying big bulky cable knit sweaters because I so often get chilly.

I'm just so nervous about checking all the right insurance boxes. My first appt was with the bariatric center coordinator type person. She set me up for the following week with nutrition and psych. I finish with that and they ask if I've had the exercise eval yet. Nooooo. So they set that up. I asked if there was anything else and they asked if I had my other 2 psych appts scheduled yet. Noooo! I'm just afraid I'm not asking about something I'm going to end up needing! The nutrition person (who my friend who had WLS 5 years ago says was crucial to her success) was very brief. Said it was no big deal and she'd have me out of the appt in 20 minutes and do the next apt over the phone in 10 minutes. I thought the nutrition stuff is important? So after my 2nd psych appt I asked the front desk person about the process for submission, etc. She tells me about the meeting with the doc and pre-op testing, which can be done in a day. Except for the thing where they put you to sleep and stick the tube down your throat (her exact words) which takes 2-3 weeks to schedule but maybe I could schedule it in advance but she's not sure. I have my heart set on getting this done in 2012. Not to mention my insurance co-pays start over on 1/1/13. Everyone seems to have just a bit of the info., but not the whole story. So I called Aetna. 4 different people couldn't even tell me if 90 days meant 90 calendar days or 3 months. They referred me back to my doc! Arghhhhhhhhhh! Maybe this should have been posted in the "rants" section!

Thank you so much! Supposedly the Bariatric center I'm going to submits all that other stuff for me? I'm doing the nutrition, psych, and exercise stuff with their staff. This is the part that drives me nuts because when I submit, I want everything done by then, no more hoops to find out after submission. Submit - approve - surgery!

Seems like everything I do lately triggers a "this time next year..." in my brain. My kids' school curriculum night, their sports events, Halloween, Thanksgiving, Christmas, New Years, everything I do with other people! All I can think about is the next time I attend whatever event it is. I CAN'T WAIT! Honestly, before I looked into this surgery I had lost all hope. I've tried every diet and even the ones that worked ended up with me regaining what I lost and more. I decided I can't diet anymore because it only makes me bigger in the end! But not this time. This time it's going to be forever. Am I the only one who thinks people sometimes dislike me because of my size? I honestly don't know if it's my crazy fat brain or actually true. But I swear there are a few people who I get really negative vibes from that I think is based solely on my weight. I wonder what they'll think of me next year?! Although, I bet I won't even care. Like I unfortunately DO now. I guess I just assume people judge me like I judge myself. And it's not pretty. But next year...!

Aetna told me they had to give a determination in 7-14 days. Is it because you had to resubmit? I'd be calling and asking for a timeframe at the very least. So sorry for the toothache to make things even worse! Hang in there. You won't even remember this part a year from now.

I see such amazing success on these boards but I can't help but wonder if they are the exceptions or the norm. Here's my dilemma: I'm hoping for surgery early to mid-December. It's very possible my husband will win an award trip to Mexico leaving March 11. Approx 3 months from date of surgery to date of departure. I have about 100 pounds to lose. This might be the first time I have ever not prayed for him NOT to win the trip. Seems like everyone at his company is pretty fit and his female boss is an exercise nut. Apparently she often points out people who need to exercise more. I know he loves me, but I do NOT want to embarrass him! The anxiety is killing me. Realistically, with a good effort toward exercise and eating (but not exercising maniacally), what do people think I could actually lose in that time????

Doxie, I'd love to think that was even an option in the future! Right now I'm just worried about the seatbelt!

Thank you all for your kind words. My husband and I have discussed it and he is just worried that I will be uncomfortable. He knows me and how I think. If I am overly self-conscious about how I look, I won't have a good time. If I'm not having a good time, neither will he. I would love for this to be the start of a new sex (what?) filled relationship for us with plane rides (what?) and everything!

Wow, is that heavy guy your brother?! ;o) Looks related, but not the same guy! Amazing transformation!

I'm trying really hard to lose some weight pre-op. I have a medical scale with those big 50 lb increments on the big weights and the little slide weight at the top. I started at 262. I'm now 252. Which means 3 more pounds until I can move that big 250 pound weight over to the 200 and use the little bar! Small victory, I know, but when I slide that chunk over from 250 to 200, it's going to feel like I've lost 50 pounds. I can't believe I've only lost 10 pounds in about 6 weeks, though. I was completely sedentary and eating anything and everything. Now I'm being very careful (not crazy) with my food and walking tons and doing yoga and Water exercise at least once or twice a week. I would have sworn I'd drop more just from the drastic change in eating and exercise.

Many people don't lose any, so it shows you're trying. That's what they are looking for.

I'm sorry to point it out but I sincerely wish people on this site would stop using a script font. Yes, it's very pretty, but almost impossible to read. And I really do want to read what you have to say! Grammar - how about nucular, for nuclear? Even newscasters do it. Makes me crazy. In written form though, we do have to lay some blame on spell check as well!