shastadaisy

I saw that too...thank you. in the same breath the presenter said something about a lapband patient and his results that were awesome -- I still have time to decide but am stumped now - I was all about VSG until this morning.

Mine is covered by bcbs BUT the group that manages my benefits (dupage medical) has these requirements before I can even see the surgeons office - they are very strong in this

I can’t even talk to the surgeon until I meet the 6 mo of supervision with monthly weigh in and nut visits I am h mo and the rules are different - Here are my requirements from my group - which is more stringent than my h mo Clinical Indications for Bariatric Surgery Growth has been completed (18 years of age or documentation of completion of bone growth). Body mass index (BMI) exceeding 40 or body mass index of 35-39 with at least two of these comorbidities (hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, sleep apnea). Medical documentation reveals the member has been morbidly obese for five years or more Medical documentation reveals the member has failed a medically-supervised program of weight reduction spanning at least 6 continuous months of documented monthly weigh-ins, occurring within the 12 months preceding the request. Such a program would be expected to consist of: Documentation of nutritional therapy or medical nutrition therapy including a very low calorie diet (e.g. MediFast or OptiFast) unless contraindicated Behavior modification or behavioral health interventions, Supervised increase in activity Pharmacologic therapy (unless contraindicated). Maintenance support to continue to encourage nutrition choices to reduce health risk factors and maintain a healthy lifestyle. [*]The surgical program must document the absence of significant psychopathology that would hinder the ability of an individual to understand the procedure or to comply with medical/surgical recommendations, or that documents psychological readiness for the surgery. Documentation of willingness to comply with preoperative and postoperative treatment plans Evaluation by an independent licensed psychologist or psychiatrist unaffiliated with the bariatric center.

this is what my group says: Clinical Indications for Bariatric Surgery Growth has been completed (18 years of age or documentation of completion of bone growth). Body mass index (BMI) exceeding 40 or body mass index of 35-39 with at least two of these comorbidities (hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, sleep apnea). Medical documentation reveals the member has been morbidly obese for five years or more Medical documentation reveals the member has failed a medically-supervised program of weight reduction spanning at least 6 continuous months of documented monthly weigh-ins, occurring within the 12 months preceding the request. Such a program would be expected to consist of: Documentation of nutritional therapy or medical nutrition therapy including a very low calorie diet (e.g. MediFast or OptiFast) unless contraindicated Behavior modification or behavioral health interventions, Supervised increase in activity Pharmacologic therapy (unless contraindicated). Maintenance support to continue to encourage nutrition choices to reduce health risk factors and maintain a healthy lifestyle. [*]The surgical program must document the absence of significant psychopathology that would hinder the ability of an individual to understand the procedure or to comply with medical/surgical recommendations, or that documents psychological readiness for the surgery. Documentation of willingness to comply with preoperative and postoperative treatment plans Evaluation by an independent licensed psychologist or psychiatrist unaffiliated with the bariatric center.

zero - but whomever is managing your account might - do you have *** or ppo and what group are you with... i’m in purgatory right now - right in the middle and was told they won’t even let me see the surgeon until I meet the pre-requirements - BCBS however told me day one - zero copay - zero deductable.

isopure is sold in the stores by the bottle

http://www.groupon.com/deals/gg-optimum-nutrition-soy-protein?c=all&p=15 seems like an awesome deal - but not if we can’t have soy...

So what Proteins - I'm a newbie. I'm also asking brands - if we can say that here I got that link from a weight lifter who competes nationally and she's a nut as well - do you think that one is poor quality -

I hope I wasn’t coming off the wrong way - they (your employer if he or she or they meet the requirements) HAVE to give you fmla - no one can tell you that you have to wait - they can kindly ASK you - but NO ONE can tell you that you have to wait to have surgery because of staffing ... that’s just not correct. here’s a scenario what if your spouse had a major illness - your boss can’t say “no you can’t help your spouse out until WE get coverage” - that’s wrong - that’s very wrong - it’s hard to believe that there was once a time when a pregnant woman would loose her job - which was one of the many reasons they created this reg - there are many facets to HR law and regulations and they just aren’t open for interpretation - I’m clearly very passionate about it - and hate when someone gets bamboozeled - Dr’s are Dr - not legal HR professionals - they sign the papers but don’t expect to get HR advice from them - that’s all - your thread took many twists and turns... NOW - that being said - to answer another note if your Dr. wrote you for FMLA and you came back earlier than he wrote you - you most certainly can get the time off - regardless of how it affects your manager - or your team - FMLA was created to protect your job - how you get paid for the time off has nothing to do with the FMLA law. Some dr’s write for an even longer period - so you can get the time off necessary to go to the dr for visits - that too CAN be covered - it’s all part of the illness it was written for - but NO manager is ever going to say that - SOME companies even cover the fmla law by the hour (I worked for a company that let one of my employees take care of her dying father one hour at a time - so if she came in an hour late - that was fmla and her job was protected) see where I’m going here? That time off had nothing to do with pay...it’s about protecting your job. I know - I’m one of those crazy hr people. Please take my passion for that occupation and realize I dont’ want someone else here or anywhere to get bamboozled. that’s all - big leap off my soapbox now.

All I was trying to point out is the federal regulation ONLY applies to protection of your job - everyone (even my husbands federal employer) gets it wrong - there is an incorrect perception that FMLA has anything to do with PAY - managers aren’t necessarily experts in fmla - they have enough on their plate - some hr people are even mistaken.

It’s open enrollment time - is there a possibility of changing plans now? Just thinking out of the box and how you can possibly still get what your looking for. I KNOW I refused to step on the scale often - so I may be in the exact same place as you when my waiting time is up in January. I have to wait six months.

that’s my personal nightmare. are they changing provider? my plan administrator has a more stringent requirement (6mo) than the insurance company - and I keep double triple quadruple checking if I will still be covered in 2013. I’m crossing fingers and toes for you.

Your beautiful and so brave to share...THANK YOU.

I had something like that from my c-section and I just ignored it...it went away eventually -

how does one AVOID even having the sleep study (when someone already has comorbitiies) ps - your even more adorable now...congrats on the wedding.

I KNOW YOU...

Even a bad HR person will know the federal regs - ultimately FMLA is separate from a paid benefit - there is a prevailing perception that is addresses pay - the reg does not address pay - it only addresses job protection - NOT all companies are required to give FMLA - it’s very detailed - and you can google the reg (do it before a long nap - because it will put you to sleep)

FMLA leave – What is it and what is covered? The FMLA allows eligible employees of covered employers to take up to 12 weeks (including intermittent leave) of unpaid, job-protected leave annually for certain family and medical reasons, including the birth or adoption of a child, caring for a seriously ill child, spouse, or parent, or the employee’s own serious health condition.

FMLA has NOTHING to do with pay. FMLA is a federal regulation that protects your job. I am an expert on FMLA. Let me know if you have any questions - but your boss is WRONG crossing FMLA with any of your company policies regarding pay.

The micromanager part - I weigh myself allot. I’ve even woken in the middle of the night - and weighed myself. Asked dear husband to HIDE the scale. Seriously a few ounces of tinkle shouldn’t be that significant to cause or disrupt sleep. oy!

Ok - so I started this journey in August - I haven’t even met the surgeon yet - I decided VSG because I initially thought lapband - but have discovered that my surgeon only does 3 surgeries - VSG, Band, RYN - so in typical webmd fashion - I’ve self diagnosed and figured out what I’m going to do. I 100% admit I could be wrong and I will make a case for VSG over anything else mostly because of this place. TODAY was what I THINK is the 3rd of 6 appointments with my PCP. My insurance covers Bariatric surgery 100/0 copay - but the group requires 6 mo of dr visits (I LOVE MY DR) and 6 mo of NUT visits...next week will be number 3 of the nut -- no one could answer if August counts as my first month of just the start of the clock ... with that being said - I’ve lost 10lbs - I’m having a hard hard hard time exercising right now...self confidence and just achey bones. I have an A1C in 29 days - and because I like to cram for a test I’m hoping to spend the next 29 days working my rotund bottom off at the healthclub/gym whatever you call it - I’ve been donating funds to...to my husbands chagrin I am a micromanager. (and an avid sarcasm enthusiast) There I said it. oh, comorbidities of Type 2 and hypertension - need to loose 200 (or whatever - cause I honestly don’t care what my final weight will BE ) I am doing this for #1 to be active and #2 to get off medications which I believe are just synthetics garbaging up my system -- So I’m at the 1/2 way point...sorta. I’ve had ONE (so far) total flake out about what the hell am I doing - I am sure I will have a few more - but I’m here...and excited about all the info I am getting from all of you - so there. I think I’ve been here a few weeks and now I did it...like that girl snickering in the back of the room waiting her turn - I finally shared the story. cathartic - meh - maybe someday it will be - right now I’m anxious...and as I told the Dr. today - I wish I did this 12 yrs ago (diabetes diagnosis) but sure as heck don’t want to look back in 3 yrs (which is about what it would take to loose this weight without the help (at least!!!)) and say I wish I did that in 2013. Whew. Aren’t you glad I posted.

interesting read. http://www.cbsnews.com/8301-204_162-57535156/weight-loss-surgery-may-lead-to-a-healthier-heart/

this is specifically for bike riders - my husband does a 400 mile ride - http://store.aerotec...CFYs7Mgod4yQARQ you can get it locally (bike store) and it’s very cheap - good luck (you can try it out for .80 -- can’t beat that!!!)

I read it out loud to my husband - because although I’m set on getting wls - having documents like this just validate my decision. makes my heart happy I’m doing it for her too (of coarse i have a girl heart - I’m a girl)!

yes - it’s true. i know they didn’t tell you that is one of our super powers... bleed for a week and we don’t die. we have many other talents.