firelle

What do you say to them? Every time I call, they just tell me it's still in review.

My Aetna insurance didn't cover any WLS either. First thing I did was talk to my employer's HR and ask them if this was something they would consider adding to the plan. They were kind enough to look into it for me and see about purchasing the rider that would add WLS to the plan. Unfortunately, our company is too small to even be offered that rider. There was just no way. They sent me all the email communication about it so I could sew for myself. Next, I looked at my husband's Anthem BSBC of Cali. He and I called their member services line and spoke to a representative who said it is indeed covered. They also showed me where to look online to see their medical policy for WLS (it shows which surgeries are covered, and what conditions you must meet, like BMI over 40 and a list of acceptable comorbidities). His open enrollment period was in Dec. Then I called the insurance coordinator at the surgeon's office and told her my situation, that I would be covered starting Jan. She said it doesn't matter to insurance if I complete the prerequisites before getting on their plan or not. So I started the monthly nutritionist appointments in August. They were only $30-$60 per visit, but my Aetna ended up covering them! Aetna also covered the initial surgeon consult, even tho they don't cover WLS itself. They did not cover the psych eval, so I had to pay $380 out of pocket. They let me set up a payment plan. I know that's a high rate, as I've seen other people's evals cost $200-$250. In Dec, my husband added our daughter and I to his plan, and verified that there's no waiting period for pre-existing conditions. I got my new insurance card at the beginning of Jan, and my info was submitted to my new ins on the 11th. Still waiting for approval, but the ins coordinator said everything is good. Hope this helps! I also decided to change surgeons, so all my nutritionist appts and psych eval were forwarded to the new surgeon. I had a consult with him at the beginning of Jan and the new ins covered it.

Yay Diva! So exciting! I talked to ins again just now. They said that the due date for my pre-auth is today at the end of the day, but that it looks like an approval nurse hasn't even been in the case to look at it yet. She said maybe the nurses are behind, and to keep waiting and calling.

I'm waiting too! It was submitted to insurance 2 weeks ago today (bcbs of California). I am a crazy nervous wreck. Really trying to focus on reading up on my soapmaking hobby and making new soap recipes, but it's hard to keep my mind off this insurance wait. I call insurance about twice a week. "it's still in review."

I think they pour the beer into dough pockets, like a beer ravioli, then fry it. Probably burns your tongue!

Good luck to both of you!

They had deep fried beer at the state fair.

Unbelievable. Just wow. (not the OP, that's believable.)

Same here. I was excited to get some ideas on what to tell my nearly 3 year old, or if she should see me in the hospital post-op. I know I would want her, but worry that she might get really scared seeing mommy laying there with all the machines around her and on her. I thought iggy had a good idea. With my daughter being so young, if something did happen, how much would she remember of me when she's older? At least she would have a heartfelt letter to hold onto.

Last night was the first time I really dreamed about the surgery. I'm waiting for insurance approval, so of course I'm thinking about it almost constantly. In my dream, I went to the surgeon's office for a checkup. They said I was approved, so we should head right over to the hospital for the surgery immediately. Then I'm suddenly in a hospital room with my husband. In comes the surgeon, who is Saul Goodman from Breaking Bad. He quickly operates on me right there in the room while I'm awake and just hanging out, then leaves my husband to sew me up with stitches. My husband gives me a line of expertly done cross-stitches. The nurse who just watched the 5 minute surgery and my husband's stitching was still in the room going over my chart. I asked her why I didn't have my surgeon, Dr. Teel. She said, "Oh, he just handles the paperwork." Then I realize I never told my boss that I would need time off of work for this surgery, so I try to get ahold of her and hope she's not too angry. Turns out, she is also at the hospital giving birth to twins (she is pregnant in real life, due in a couple months with one baby lol). So, feeling fine and wonderful, I jump out of the bed and start roaming the halls trying to find her. Of course the hospital is a giant maze-like structure. I find out the maternity wing is on Pink Level 5, and go the elevators. The elevators are tubes that hold one person at a time. There are different sizes, small, medium, large, and super huge. Also a Pepsi machine. I have to get into the super huge tube and am embarrassed because there are high school girls standing nearby. Finally I get to the area where my boss should be, but it's like a train station waiting area. A bunch of large benches with people sitting around, bored, and a dusty area in the back with old Christmas decorations and some empty store display shelves. I can't find her, and the list of patients on the wall doesn't list her. Then I woke up. Anyone want to go next?

Haha, I love that not only did you decide to have beer right after surgery, but that the hospital cafeteria served it!

Since the "ONE post" thing keeps getting brought up as a negative thing for some reason.... I guess I'd have to ask what other posts you guys think the OP should have made before this, and why? It's not like they're interested in Protein shake reviews, or want to ask questions or post recipe ideas for crying out loud. When I did a google search for "vertical sleeve gastrectomy", this forum is the second search result after a medical encyclopedia definition page. This forum is huge and states that it's the #1 place to talk about this surgery. Now I may be jumping out on a limb here, but this seems to be the perfect place for someone to be who wants to get their sister's story heard. The OP came here, made an account, and posted their sister's story. That only takes 1 post to accomplish.

I'm sorry to hear about your sister. I can't imagine how difficult and scary it's been for her and your whole family. Thanks for sharing her story, and I'm glad you did. I know surgery has its risks, but it's easy to look at a piece of paper that lists the risks, and not really think about it too deeply. It's easy for me to just think about the end result of being thin and healthy, and never give a second thought to any complications that might happen. Your sister's story definitely forced me to get my head out of the clouds. While I am still going the route of surgery, I appreciate you making a serious complication very real for me, and wish your sister and family the best. You certainly don't sound like an idiot or "mentally challenged" to me, you sound like someone who loves her sister very much and has endured a lot of pain and scares, and wants other people to know her story. I'm sorry the other poster didn't see things that way and had to resort to name calling.

You are beautiful, brave, and strong!!

Hey there, I'm a newb too! The office submitted my paperwork to insurance on Wednesday, and I've been thinking about it pretty much nonstop since. I can't wait to hear good news and get the ball rolling on a surgery date. I know the pre-op diet will be tough, but I keep telling myself it will be the last un-aided diet I'll ever have. We can do this!

My mom is supportive of me getting surgery (I'm waiting for ins approval right now), but she is already going into preach mode, and it's driving me crazy. She keeps randomly telling me obvious things like that I'll need to exercise a lot and perhaps walk 15 minutes in the morning and 15 minutes after work, and that I'll need to "pay more attention" to nutrition labels and not eat out so often, etc. Yes, mother.

Watch out that the water isn't too warm! I asked my NUT how hot I can make the water for Unjury chicken soup protein powder, and she said the protein starts to break down above 140f.

Way to go! Can't wait until I'm there also!

Hi! I'm brand spankin new here and wanted to dive in and introduce myself. I originally went to my surgeon because he is known to perform the DS, but he sat with me for an hour straight talking me out of that surgery and towards the sleeve. Basically, he is adamant that I can achieve my goals with the sleeve, and that the DS would give me a poorer quality of life in the long run. He was brutally honest with me, and though it wasn't what I wanted to hear at the time, I really trust what he and everyone else is saying. My info was submitted to insurance yesterday, and now I'm waiting for approval. I've been on the pre-op journey since July (6 months of nutrition appts, etc), and have been researching the DS since then. I don't know much at all about the Sleeve, so here I am. This looks like the place to learn a lot. So... I'm 33, and live in northwest Ohio with my husband and our daughter who will be 3 next month. I have 200 extra pounds to lose (BMI 57), not only for better health, but I want to be able to run and play with my daughter freely. I work in a lab, and can take breaks whenever I need, so snacking/eating/whatever should be ok. I'm a little concerned about getting my fluids in - it's a sterile lab, and kind of a pain to take all the lab gear off, change shoes, etc, to just come out to the break room for a sip of Water. I usually gulp down a glass every couple hours, but that will have to change. Anyway, enough rambling. I'm excited to be here!

Thanks everyone! Still a little overwhelmed with just how much information is on this site. So glad I found it. Rybecca, I'm seeing Dr. Teel in Dayton, but I live around Findlay.

Best of luck to you!!