Chris10

Hi Everyone! Well this is my second time going through this process! This time I have Medi-Cal and it's taking longer to get into appointments. Over a year ago I had Anthem Blue Cross, went through all of the requirements, and was scheduled to have surgery December 2013. I had a BMI of 41 and had joint issues and poly cystic ovarian syndrom (PCOS). I was told without extreme weight loss it would be very difficult for me to have children. Well at the end of October I found out I was pregnant! Yay! However, that meant I had to postpone my surgery. I ended up having some complications and was put on bed rest half way through the pregnancy. My son was born perfectly healthy in June. Unfortunately, I was still in my year probation at work and they released me (understandably) because I couldn't work. That caused me to lose my insurance and go onto Medi-Cal. Now I am on Central California Alliance for Health through Medi-Cal. I talked to my surgeon and they accept my insurance but because it's been over a year I have to go through the whole process again. I had to switch primary care doctors and had an appointment to get my referral. The doctor I saw rescheduled me to see the main doctor in the office because only she is allowed to give referrals. She is super busy so I have to wait until December to see her. Does anyone else have alliance?? I want to get an idea of the requirements so that I can request any referrals I'll need all in one shot. Thanks in advance! Christen

Thanks! With alliance when you change your primary doctor it doesn't go into effect until the next month. So I decided to just wait and see this doctor. I went in today and she said they are going to process the referral and I should get a letter and hear from the bariatric surgeon within a few weeks. Luckily since I've already gone through everything before she said it shouldn't be too long of a process.

After talking with more people I decided not to go with my previous surgeon because of their mandatory purchase of 4 weeks of food for $4000. So after researching more i found another surgeon who is closer to me And has good reviews. Tonight I went to his offices seminar and should receive a call about scheduling my consultation in a few days. I spoke with one of his offices staff and she said all my previous requirements should transfer over fine but they might have to resubmit my surgery request if I was approved only for surgery with my previous doc. Wish me luck I hope I can move through this quickly and get a surgery date!

Hello, So I spoke with my surgeons office today and scheduled my preop appt. however, they informed me that I will have to pay $3,900 for their post op meal plan. I believe she said it would be a month of supplies. She said that normally the patient pays out of pocket and it doesn't count toward the deductible. I asked her to submit it to my insurance to see if they will cover it so that it will at least count toward my deductible. Anyone ever heard of this before? I think it is the Optifast program. I have anthem blue cross with SISC II. Does anyone know if prescribed meals are covered? I really don't want to pay 4 grand for a month of food lol

Well I heard back from the office. The food plan truly is non-optional. I can't buy it from anywhere else. If I want to have my surgery done there I have to buy it. Time to look for a new surgeon.

Hello, So my companies insurance is in open enrollment right now. I have anthem blue cross through SISC II. I'm currently on a high deductible plan and would like to switch to the 100% coverage. I was recently approved for the gastric bypass but haven't had the surgery yet. Will I have to reapply for my approval because I'm changing plans? Or will I still be approved because I'm still with the same insurance company? Anyone have any experience with this? I'm going to call my insurance tomorrow once they open but just curious if anyone else has done this.

Ok great hopefully well be able to work this out and I won't have to change surgeons but if I do have to its good to know im still approved.

Yea there is no way I'm going to pay that. Basically if my insurance covers it great! If not they need to offer me a more affordable option or ill find another surgeon. If I'm already approved and I switch surgeons do I have to reapply for approval?

So to give an update: The official amount for the meals is $3950.00! And it is only a 4 week plan! And it is not optional. I really trust this doctor (I mean I drive 2 stinking hours just to get to him) but that is ridiculous! I really hope this is a misunderstanding. I emailed the office back again requesting more information and documents on everything. I told them that I do not feel comfortable paying that much money for a month of food. When I spoke to them on the phone something was mentioned about looking into buying it from costco but its probably not much cheaper. I'm thinking they might just require some sort of meal plan the first month and are just trying to get me to buy from them. Hopefully I'll be able to sort this out! I will have a bit more time now as I'm moving my surgery into December. It is currently open enrollment with my insurance. The plan I'm on now is a high deductible plan. If I switch to the 100% coverage plan it will only cost me $3500 a year. On my current plan I have to pay $900 a year but $5000 out of pocket before I get 100% coverage. My new plan will kick in October 1st so I was hoping to schedule early October. Sadly my doctor is going vacation during October. Buuuut.. My boss is going on maternity leave later in October! Lol! (We're the only two in our department so I can't leave) so I think early December will be best. It really works out for the better anyways! By December ill have much more sick time built up, my job will be past the busy season, and I'll have 100% coverage instead of having to pay 5K! Sorry for the crazy long post. I'll hopefully learn more about this meal thing tomorrow!

Ya this is supposed to include all the meals and check ups with the doc.I have a $1200.00 deductible before my insurance pays 90% then once I reach $5000 total out of pocket I'm covered 100%. So if I have to pay I don't mind I just want it to count toward my deductible lol! I would much rather prefer the $500 though!! I just emailed the office back asking if it is optional and how long it will last. (like does it cover 1 year of meals or only 1 month? lol)

My date is September 24th

Woo hoo! I just found out my surgery is approved. I'm so excited! My surgery should be on Sept 24 so long as the hospital has a surgery room available that day.

So I'm just curious about how much excess/loose skin people have been experiencing? I'm 25 5'6" and 240 lbs. My surgery is scheduled for September 24th and even if I have a lot of loose skin ill just be thrilled to improve my fertility and functionality! Is there anything I can do to improve the chances of helping my skin tighten up a little? I plan on exercising regularly and staying hydrated. Any other tips?

Thanks for the info Makes me feel a bit better

thanks

No I live in Turlock but the surgeon I want is in Roseville

Officially scheduled! My day is September 24 at 9:30 am

Well I started looking into the surgery over a year ago but I started the entire process in June. I'm having Dr. Waldrep do my surgery. He did my dads and sisters so I trust him.

I can only see the quote

Your from the same area as me! Where are you having your surgery if you don't mind me asking? I'm going to Roseville.

Haha that would be awesome! the 23rd was a choice for me but I want a Tuesday so I'll be closer to the weekend. That way I don't have to miss that extra day of work

I'm sure I drove my doctors office crazy! I was calling or emailing almost every day checking to make sure they were receiving everything. Once they told me they submitted it I began bugging the insurance lol!

Congrats! My boss told me that Anthem Blue Cross has always been very fast on all approvals she's seen

Mine was submitted on Monday and I received approval Wednesday around 4:30. I have Anthem Blue Cross. I don't know if it sped anything up but I emailed my insurance at around 3:00pm on Wednesday asking for confirmation that they received my approval request! lol

Congrats shawna! Keep me updated! I was just super excited at first but now the nerves are kicking in lol