Sharon1964

Wondering what you ended up doing.

Take your height without your shoes on. And yanno, we shrink as we get older.

I have heard of a few people that have been successful, but ONLY because the insurance company misled them and told them they were covered for the surgery for a period of around six months or so before discovering the mistake (while they were still in the preop phase). If the insurance company hasn't done anything like that, I would say it really isn't an avenue to put any hope into. Your "need" has nothing to do with it. Insurance is a business; it's not about healthcare.

Okay, so I bought a box of ECODRINK at costco. Tried the blueberry/pomegranate flavor this morning. Reminded me of the colonoscopy prep drink that made me barf. I figured, maybe it's too strong. So I diluted it by half with Water. Still barf-worthy. Stirred in a packet of splenda. Better, but for someone who drinks water all day at work, and peach tea crystal light at home, I'm just having a very hard time choking this stuff down. I even put it in the freezer for a while to get it extra-cold. Only helped a little. Are you guys drinking this stuff straight? Is there a secret I'm missing? If I can't figure out a way to choke this stuff down, it's going back to Costco. HELP!

I think you should be honest and call your surgeon. If they don't want to operate, it's for a good reason. Maybe they can switch you with someone that is scheduled for next week.

I think you're misunderstanding the nutrition/program requirement. You have to have some sort of physician-involved program for six months. I went to my pcp once a month for six months and he did all of the documentation and nutrition/exercise counseling. At the end, he faxed his visit reports over to the surgeon who included them in the package to insurance to get auth. Instead of seeing an MD once a month, you can see a registered dietician that is part of a medical practice. You can also join a program like Weight Watchers, with medical supervision. You don't have to wait six months and THEN join a program (you don't actually have to join a program at all).

No. Many if not all of those are requirements by your surgeon.

It could be any number of things... nutritionist, classes, etc. Are you done with mental health? They might want to do some psych testing that isn't covered by your insurance. You might want to call them back and ask them what they believe you will be paying for.

I highlighted some things in your post that I think are important. You feel like you're not being heard, but when people gave you suggestions you don't like that either. They're telling you what worked for them; most of the time, that's all someone knows - what worked for them. I'm unclear as to what you wanted from them. Why do you feel you need to experience a rapid weight loss to be successful? You've lost over 80 pounds. OVER EIGHTY POUNDS! Congratulations! That is awesome! Does it matter if you lost 80 pounds in 5 months or 80 pounds in 15 months? Not really, you would still be exactly where you are today, at 1 1/2 yrs out. What are you trying to say that you feel you're not being heard? That it is easy for some people and not for others? Yes, it is. That not the same exact thing works for everyone (upping calories, not upping calories)? Yep, true. Do you feel like you got promised the "happily ever after" and no one delivered? As a creaky, cranky old lady, I can tell you that a whole heck of a lot of things never get delivered. Think about this... in 1 1/2 years from now, what will your life be like? Are you going to be in the exact same place you are now, just a year and a half older? Or are you going to pull yourself up, get a grip, knock off eating the crap you're eating, and re-dedicate yourself to LIVING YOUR LIFE??

I started the process in November of last year. My surgery date is now about 4 1/2 weeks away. I didn't think it would ever get here. I read these boards and saw all kinds of people getting their surgery and saying, "don't worry, the time will fly by." Well, you know what, it pretty much has. I figured, it took me nine months to grow a human being, I can take six months or so to go through this process.

Why are you anticipating that this is going to be negative? Work on some positive thoughts and statements instead: I'm excited about this phase of the process... it means I'm almost there. When I feel hunger, I'm going to have what I'm allowed. I'm ready to put aside the food and habits that got me to this place. I can't wait!

I don't think calling a hospital is going to help you. Call United and get your benefits booklet, if you don't already have it, and ask them specifically for their bariatric surgery policy in writing. Is this a group plan through employment or an individual plan?

I would check again, that definitely doesn't sound right. What that amounts to is a 5-year pre-existing condition waiting period, which is not legal in any circumstance that I can think of.

Blue Shield of California is owned by California Physicians Services (the 1099 we get from them at the end of the year says "California Physicians Services dba Blue Shield of California"). It was originally created by the California Medical Association. Empire Blue Cross Blue Shield is still owned by Wellpoint, I think. In any case, two entirely different companies who share a name and usually have a reciprocal agreement to use each other's panels of doctors.

I'd have a little more respect if they were just honest about it. "I ate (whatever) and I feel bad, please help me feel better about it." Not that I would, of course.

My surgeon says no bread or crackers for the first six months. Since all of our answers are different, what does YOUR surgeon say?

Well, my insurance, Blue Shield of California, dropped their six month requirement as of July 1, 2015. I already "did my time" and had my approval before the end of June. My surgery is in August because my surgeon is booked that far out. And he's doing mine on a Saturday.

Grilled cheese? My surgeon says no bread, crackers or Pasta for six months after surgery. His nutritionist says it forms a gummy paste in your tummy which isn't good for it.

I had to have six months of "a supervised weight loss program with monthly visits". I did the visits with my primary care doctor. Weight loss was not required; just documentation that we discussed eating, exercise, etc.

I love coming here and reading these! Keep up the good work, everybody!

Because those things are not surgery, they are office visits, radiology, etc. Pretty much everything I had done before I was approved could be done for someone not having surgery. I had: Surgical consultation nutritional counseling psych evaluation upper and lower endoscopy colonoscopy pap smear lab work

If you're doing it to get a quicker surgery date, I would call your surgeon's office and ask if it matters. It wouldn't matter at all with my surgeon. He doesn't require weight loss before surgery - he says if you could do it on your own you wouldn't need him. I had to meet insurance and surgeon requirements and then I was approved. They gave me the next available spot, which is in August.

I am a big person with a big personality. I think most people would be afraid to say anything about "easy way out" to me. I'm actually waiting for that day, so I can make my lower lip tremble, produce a small tear brimming on my eye, and say, very quietly, "why would you say something so hurtful and mean?"

I didn't read the whole 55 pages, but it does look flexible to me. I just got my approval, so the new guidelines don't apply to me. If I were you, I would call Blue Shield and ask them specifically.

Can I 'like' this about a hundred times??