MrsB2007

I will be having surgery near by. At PV hospital

Oh my goddddddd.... I have been a basket case waiting for today!! ¤ Az mercy care (medicaid) ¤ 6 months supervised diet plan (gained 3lbs total but had medical reasons that dr noted) ¤ 6 months of food logs ¤ Psych eval ¤ sleep study ¤ Blood work ¤ Nutritionist visit Dr submitted last friday jan 2nd.. I called insurance company to find out if they received it.. They had no record.. I called back today and spoke to a guy who said they received it AND approved it! Drs office is at lunch now so i cant call yet.. But they said once insurance approves my surgery will be about 1 week later!

My drs office said they sent paperwork over...Called insurance and the insurance company said they didnt get anything..Called back a few days later still nothing..Called today and found out they did receive the paperwork and approved it too. Be patient. You've come this far..A few more days wont hurt.

Yes.. Trust the coordinator.. They do this a lot! They know what is expected and what would disqualify you.

Question 1--people say ins goes off starting BMI to qualify.. However if you lose too much they think you can do it without surgery. Question 2...i would be careful putting off 3rd visit..dont let it go too far because you may have to start 3 months all over..and usually unless your ins specifically says you need to show weight loss i wouldnt worry..i would however worry about weight gain as many have been denied for even gaining 1lb.

Yay!! My drs office sent mine over last friday. They said my ins will respond within 14 days.

Its the same as saying just eat better...work out more..etc. Maybe they have tried all of that and weight yo-yos like the rest of us here.. Maybe its creeping up along with other health issues. Unless we know them and are trained as medical professionals we have no right to judge. After all.... Look how many times people looked at us and said since you arent 500lbs u shouldnt get surgery.. just eat better or eat less. Not fair at all.

I know insurance companies in USA have certain requirements prior to surgery.. What about the surgeons in Mexico? What do they require before surgery such as BMI, comorbidities, % of weight loss prior to surgery etc? My dr will be submitting my stuff to insurance next week. Insurance can take up to 2 weeks for a decision. I am preparing for a possible surgery in Mexico if my insurance denies me and any appeals. I just cant find where to find the whole process for the drs in Mexico. Thanks

Today is my last weigh in also... In 1.5hr actually. I gathered everything to take to the surgeon to submit to insurance. Quicker than requesting everything from the drs office. Wish me luck!! Looking at the first part or middle of Jan if ins approves.

Any update on this??? I have this insurance and was wondering something similiar about weight gain due to medication.. My dr noted it, but still a concern of mine.

Sorry I just need to rant.. My husband is probably SO sick of hearing me obsess over everything..Who is with me?! Surely I'm not the only one! Oh man! 2 more weeks until my last weigh in. phew. Now that's off my chest... Lets see............... >> Psych Eval done & passed >> Nutritionist visit(s) done >> sleep study (no sleep apnea!) >> 5 other monthly weigh ins & supervised diet completed >> food journaling done >> Met with surgeon Now, I go back and obsess over every single thing. What did I miss? I feel like something wasnt done! My weight jumped up and down (very few lbs in either direction). I again obsess over that! Hmm..Lets start a list of what I have obsessed over, and researched until I was blue in the face! >> Making sure every appointment was made and I actually went as scheduled. >> Insurance requirements... What does the internet say (other patients) vs my doctors office? >> Will I be denied due to weight gain (even though I've lost it...weight gain due to depo shot & other surgery preventing as much exercise)? >> Will the insurance go by other factors (as comorbidities besides the typical high blood pressure, diabeties, sleep apnea, etc)?? >> DR's office & website both say theres about 30 comorbidities that insurance will look at besides the above. If thats the case, I'm good on that aspect. I figure the DRs office knows what they are talking about...but still nerve racking. FYI: insurance website says up to 2 weeks for decision. DRs office says once approval is received then surgery will be 1 week after. Okay now that rant is done (for now- HA HA)............ What did you obsess over and over and over about?

I went for over 1 year..because i wanted to try that as my absolute last resort of weight loss before surgery. However it varies by ins.. Most require 1 or 2 visits total i believe.. As far as how close to the surgery date im not sure.

My BMI is about 37. My family has tons of health issues listed above. Im trying to avoid that at all costs. I know with family history and the way things look now ill be there soon if something doesnt give

Yeah miss mac.. That is similar to the list my dr uses.. I hope my ins will consider because i have zero typical comorbs such as sleep apnea, high bp, etc.

Sounds like pure jealousy!! Youre obviously turnin heads in a positive way and theyre not. So sad that these are "adults"

Assuming insurance approves i should be the first week in Jan or the middle. Im soo scared they will deny. Its almost been too easy (not literally, but you get the idea.)

Easiest way to find out is to call and ask. In AZ we dont pay anything for surgeries.

I have been dealing with the same issue. My weight has fluctuated a pound or two up or down every month the last 6 months. The coordinator says not to worry about it as long as its not a drastic change. I'm still nervous though but they know what they're doing

My PCP wrote a letter of med nec and has prediabeties as the comorb... Has anyone had ins approve with just this? I dont have anything else as comorb, and BMI roughly 36-37. I only have 2 more weigh ins, every other test was completed and passed. I just dont want to get to the end and them deny because its not full blown diabeties yet.

What BMI or other conditions do you have

My insurance (AHCCCS - Mercy Care) requires BMI of 35+ with 1 comorbidity. My BMI is over 36, but I am unsure if I have any comorbidities. My PCP just had me do a ton of blood work yesterday (liver, kidneys, diabeties checks, WBC check, etc etc etc). This surgeons office has a list of comorbidities.. Which, according to that particular list I have about 3 or 4 of them (anxiety, depression, back pain, migranes, headaches etc). Has anyone been approved with issues other than the typical sleep apnea, diabeties, high blood pressure, etc??? (regardless of ins co) I have read a lot about the NO weight gain thing. I have been seeing a nutritionist, eating right, exercising regularly, etc.. but my GYNO put me on the Depo shot for my endometriosis pain. The Depo has made me gain 10lbs (prior to my first weigh in).. If the weight gain continues can I tell the ins co the depo caused weight gain, not my poor eating habits? I am confident I can manage my weight (and lose some here and there even) but with the depo theres no telling how much I will gain anyway. Anyone had this issue? What to do?

Last night I went for my sleep study. The tech was setting everything up, explaining how this was going to work, etc. We some how got on the topic of WLS. He didnt know I was going for WLS & thats why my DR sent me for the study. He looked shocked that I would be considering the WLS. He said to me that I wasnt even that big, wls is more for people that are like 600lbs, and that he thinks DRs are just pushing surgery for so many people as a money maker. *Probably why they are sending me for this sleep study, cuz it would help qualify me for the surgery...not that they are really concerned that somebody my age *27* could possibly have it. Yes, granted I am not 300, 400, 500 or 600lbs.. First of all..... Screw you dude! I told him that by medical standards I am considered obese (maybe morbidly) & thats not healthy for anyone. I do hold my weight very well generally speaking so I do not look like I weigh quite as much as I do...but lately my BMI has bounced between 37 & close to 40. He then tells me that if I just bust my @$$ exercising daily and eat right that the weight would fall off because of how old I am. Oh really? Thats it? What about this last year busting my behind working out & eating according to the nutritionist to only lose a few lbs total?? Well, he thinks I just need to stick with it. Dont give up. WLS is giving up? No, its not. I have always been a bigger person (except maybe mid-teenage years I wasnt quite as big). But for the last 8 years I have been extremely over weight, struggling to knock some weight off, etc. So, dont tell me that I'm just not trying hard enough. Mind you, this is a man who was maybe 150lbs max and thats probably the biggest he's ever been...If you dont know the struggle, dont bash those who have struggled & who are trying to better themselves. Most ins co make you work to qualify for WLS..They just dont say "oh...okay, lets go with this because you want to do it." What made this even better (insert sarcasm here).... He kept referencing this 600lb man that he saw not too long ago.. He said all this man talked about was "fried chicken, fast foods , etc" and how this was a perfect example of why / how Drs are just pushing for surgeries (even with obvious signs that somebody is going to fail). What kind of ignorant remarks have you heard from people about your WLS journey?

2 more weigh-ins left and sleep study tomorrow! Ahh getting close.. Random FYI: this month i actually lost some weight vs gaining. So scared ins will deny me. Maybe if i can lose a few lbs and be less than the initial weight it wont matter if i gained in between? I had gained weight (3lbs total over 3 months) due to a depo shot, but lost some weight since i stopped getting the injections.

3 weigh ins completed, nutritionist done and now psych eval done. It was super easy and quick. The guy was hard to read though! But he had no concerns for me, and said I was remarkable compared to others he has evaluated. Woohoo! So, i just need my sleep study (a week and a half from now) and 3 more weigh ins! Getting anxious as it gets to the end.

So, i have been following a nutritionists diet.. I have been reading here that many things that my nut is having me eat i wont be able to eat afterwards. The brown rice, whole wheat bread etc (other items too). I dont care for those food items as it is.. I just dont get why they have u stress on eating these items and then after surgery its a no no. I know they want to make sure you follow a diet plan, but why so dramatic difference? Is it just because you need those items now but not after surgery?