majorsmama
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Everything posted by majorsmama
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I am using the nutritionist at my surgeons office. I called Aetna and they said that's fine as long as she documents my weight loss, exercise, and behavior modifications. But aside from the weight loss, I can really just make up the other stuff so it just seemed odd to me that they are trusting what I tell the nutritionist. She's just told me cut out carbs for the most part.
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I had my first appt with my surgeon on the 6th I think? At the end of the consult they scheduled my next nut appt and they had me walk downstairs to the psychologists office and schedule my psych eval. That's all I've gotten done yet. I don't have to have a sleep study so I believe all that's left is the ekg, blood work and endoscopy. I asked when I could schedule the endoscopy and they told me that would be later in the process. I'm not concerned about it though because these surgeons and their employees do this for a living and I'm pretty confident they've done it plenty of times before.
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Anyone gain weight and still got approved (Aetna)
majorsmama replied to dede0314's topic in Insurance & Financing
You can't have a net gain so be prepared to have to appeal. Was it really the medication that caused you to gain weight or did you not diet and exercise as much as you should have? -
For those who had surgery in the US and used insurance... From your initial consultation with the surgeon, to the day of surgery ... How long did that entire process take?
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If you soak the Chia seeds in water or milk ahead of time, they swell and become completely soft like tapioca. They need a thin liquid to sit in. When they swell they turn kind of translucent and white. So try pre-soaking them overnight in just water before tossing them out.
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Out of pocket expense?
majorsmama replied to simplyrita8's topic in PRE-Operation Weight Loss Surgery Q&A
My insurances max OOP is $2,000 so hopefully no more than that. At my first appt with the surgeon I had to pay my $500 deductible and I know I will have co-pays with each visit. Not exactly cheap but not bad considering some people pay $10k+. -
Hi all! I am hoping to get sleeved early next year. My insurance covers bariatric surgery and I meet the requirements so I will probably not have an issue getting approved. I've been starting to question whether or not Mexico may be a better option for me. The reasons being, the price isn't very much more than I would fork over for deductibles, co-pays, etc if using my insurance. Plus, I wouldn't have to do the 90 day diet that my insurance requires which would really speed things up! No lengthy approval process, no possible denial, fewer headaches, etc. So I'm just curious, what made you all choose Mexico? I assume most don't have bariatric coverage on your insurance but is there anyone out there like me, who just wanted a faster process with less hoops to jump through?
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Hi all, I am looking for suggestions for Protein powders (not ready made shakes). I'm interested in the Isopure zero carb but from what I've read, the flavors are lousy. What kind of powder do you use and what flavor?
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It can come from any doctor. Ob/gyn, urgent care visits, etc.
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I ended up speaking to Aetna and although they changed the verbiage, they are still looking for a 2 year weight history. That's what they told me they want when your surgeon's office submits for approval. And the 40 BMI or 35 with co-morbidities applies. If you have no co-morbidities, then they want to see that your BMI has been over 40 for two years.
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I spoke the the WLS "guru" from Aetna yesterday and she told me that there can't be a gain from the first weigh-in to the last. She said those are the weights they look at. It's a little frustrating that different people get different answers.
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From the day of your initial consultation with your surgeon, to the day of surgery... How long did the entire process take? I'm just wanting to know what to expect realistically. I have to do a 90-day diet for my insurance (Aetna) but a friend of mine with the same insurance said it took her an entire 7 months with all the testing and whatnot.
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You will definitely need a seatbelt extender and honestly, you'll probably get some dirty looks. . If you can afford it, purchasing two seats will really help to curb your anxiety because then you don't have to worry about fitting and/or who is sitting next to you. Good luck!
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I can't find any info on him however someone said in another post that he's plenty experienced, he's just new to the tourism surgery market. To be honest though, I personally wouldn't choose to put my life in the hands of the lowest priced guy. But that's just me.
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Ah! Penny! Why?!?!?(My 600 lb life)
majorsmama replied to Kramer17's topic in Gastric Sleeve Surgery Forums
I LOVE this show and can't wait for the new season to begin. The episode with Penny was by far the most difficult to watch. She is legitimately delusional. And I don't really care about her, but she has that beautiful little boy who doesn't deserve to have a mother like her. She is sick in her head and her husband is an enabler and I feel like that child is doomed with those kinds of role models in his life. -
Denial after Precertification Approval (Aetna)?
majorsmama replied to NewBeginning2015's topic in Insurance & Financing
How are you feeling after surgery? How has the recovery been? -
Just curious, with your policy did you not have the option to do the 90-day weight loss regimen?
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Denial after Precertification Approval (Aetna)?
majorsmama replied to NewBeginning2015's topic in Insurance & Financing
Hi! I have Aetna too so can I ask a couple of questions??? 1) How long did your approval process take? 2) Was Aetna easy for you and/or your surgeons office to work with? Were there any hiccups along the way? 3) How long from the end of your 90-day program/diet until your surgery date? 4) Did Aetna require anything other than the 90-day diet? Did they make you submit to a psych eval? Thanks and GOOD LUCK! -
Thanks everyone! I have doctors records from May 2013, but prior to that I had not seen a dr in a couple years. Odds are, with my 90-day diet I won't be getting the surgery prior to May, but in the case I can, I wanted to make sure I had a documented weight prior to May but the only one I have is from the health assessment from Aetna.
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Hi there. I was just wondering how your approval process went. Did you end up getting the surgery?
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Yeah no sense in going to a clinic since they will give you the same kind of test you took at home. I would just call your Ob/gyn on Monday and schedule an appt.
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What took you to Mexico?
majorsmama replied to majorsmama's topic in Mexico & Self-Pay Weight Loss Surgery
While the price can't be beat, I'm having trouble finding any reviews or feedback on Dr Lopez! It's a little concerning. Maybe he's new to the game? Anyway, good luck! Your experience with him will probably be the first one many of us hear about!