prettyCali916

Hi! I don't have blue shield but I work in the health insurance industry. Some Blue Shield plans are HMO so those plans have no deductible or coinsurance, just an office visit copayment if that. It all depends. If you have coinsurance that means you have a PPO more than likely. Let's say your hospital bill is $10,000, your deductible is $500, you have a $4000 out of pocket maximum and your plan is an 80/20. Assuming you are starting with nothing paid towards your deductible, you have to meet that first. So that's $10,000 minus $500 leaving $9500. Then you are responsible for 20% of what's left. That's because of the 80/20 we mentioned before (which could be 90/10 or something else even). So you now owe 0.20*9500. That is $1900. So you have to pay that on top of your $500 deductible for a grand total of $2400. The insurance company then pays the rest of the bill. If you ever get to the point where you have met your deductible and paid $4000 out of pocket cumulatively over a year, then anything after that would be covered at 100% by the insurance company. Until the end of the year that is, then it starts all over again. Hope that helps!!!

Hi everyone - I've been a member for some weeks now but have just gotten comfortable posting here and there. About me: I am a military wife and thanks to my amazing, selfless and just all-around wonderful hubby and his military service, I have Tricare (United Healthcare Military West) insurance and I'm about to get my surgery date. My weight gain began when I left my father's house and entered into the real world sans maids, which meant no regular healthy meals prepared on schedule every day which is how I grew up. I was 125lbs at 21 but by the time I got married in 2009 at 23, I was 201. End of that year I was 231. Between 2010 and 2012 I began Zumba and became a certified personal trainer and got down to 181 and was quite happy there until I dislocated my knee cap one day at the gym. This led to some serious weight gain and I was at 240lbs. So I decided to do Optifast through Kaiser (medically supervised) which I did and got back to 207 by June 2013. Well, around this time my knee started bugging me again so I had surgery to repair the damage from the initial dislocation. I gained 20lbs right after surgery in October 2013. My husband had just returned from his 2nd deployment and I had promised him that when he got back we could finally have a baby. I didn't know before he left that I would have surgery but a promise is a promise right? Jan 2014 I was pregnant and we welcomed our lovely daughter in September 2014. I left the hospital at 310 lbs. fast forward to now, I have gotten myself down to 282. I've been going up and down from 252 and 282 this whole year. I decided in mid November that I would finally have the surgery. Met with Bariatrician on 12/1 - said I'm a good candidate and that after talking to Tricare reps, was informed that my 6 months on the Kaiser program from 2013 meets the insurance requirement of having a documented attempt at weight loss before approval, so I was told I needed to have one dietician visit to complete requirements. Had EKG same day. She also put in an order for pre-op labs, GI, etc. 12/2 - Met with surgeon (amazing dr!!!) and he agreed that I was a great candidate and he was especially interested to see my results as far as my knee issue. 12/3 - had psych eval and was told no red flags and that I would be recommended for surgery. 12/4 - had labs, chest X-ray and scheduled GI X-ray for 12/11. Dietician appt. is 12/8 - will receive pre and post diet instructions, information on general eating, as well as final green light to be scheduled by surgeon. Was told surgery will most likely be mid January so fingers crossed for that! It's moving faster than I expected and I'm really excited. There's a lot of good information on the forum and I can't wait to learn more and share more. Especially looking forward to joining a monthly group once I find out my surgery date. God bless you all on your journeys!

Update: I was told that they will lock my items in a locker and security will bring them to me when I get to my room. That's awesome!!!

Microwave pepperoni to make crunchy pepperoni chips.

Could be... I've made all sorts of special requests (like ordering the "add on" portions of shrimp or whatever) instead of a full meal... Or half portion... And haven't had any trouble even without the card. I typically don't want what's on the kid menu, so that's something I haven't tried. It's typically fried or carb heavy. I think it may also depend on if you are eating at a chain that has specific rules or an independent restaurant. I do order kids meals at a couple of fast food places--chick fil a and their grilled nuggets Come to mind--and haven't been questioned at all. Totally agree on the kids menu being fatty. And I do the add-on item thing too now...usually because I want to try everything lol. I'm sure it will be a completely different story once I'm sleeved. I've seen some middle to higher priced menus with the printed msg on it saying it's not allowed but like you said, it seems that there are other ways around it.

I think it would make a difference... I'm sure sometimes restaurants think people are trying to order off the kids menu to be cheap. To know that the request is backed by a dr might make them way more likely to oblige.

Hi Knall! I haven't had my surgery yet - I get my surgery date this week but my consult was this past Wednesday and my doctor is out here in Northern CA and he's with The Hernreid Center which is affiliated with Sutter Hospital. We were discussing eating after surgery at my consult and he wanted to know what my approach would be if I did go out to eat and I said I probably wouldn't eat out for several months. He said I didn't have to do that and that once I'm on solids he's more than ok with me eating soups and salads while dining out, or the kids portions, and that's how it came up.

Great ideas - I'm poaching some of them! I hope you have a quick recovery! You made me think of something else...soluble Fiber. It will help going to the bathroom. I had a c-section a year ago and that was something all my c-section friends told me to get before surgery since the last thing you would want to do is push too hard and tear stitches. Same thing applies here I feel. Made all the difference. Some other people have posted about a tea called "Smooth Move" - sounds like it works well too!

Thanks so much! Thank you!!! I wish you the best too - speedy surgery date, quick recovery time and excellent results!!! As soon as I had decided to have the surgery I anticipated months and months of waiting but I'm really happy about it not being that long! I mean, at the end of the first appointment regarding this surgery the bariatrician says she's sending a tech in to do the EKG. I'm all "now? In this same room?" And she says "yeah! Oh do you have to be back to work?" I said no way and called and told my boss I would be back from lunch a little later... Just really happy and excited...lots of mental preparation going on.

Lol...well, maybe not then! Lmao. That would be me lol.

Lol!!! I haven't had my surgery yet (probably will be early January - I'll find out on Tuesday) but I'm really glad I read this thread because up until now I have always thought it would only be an issue during the first week or so. Ugh! One more thing to deal with...thanks for the heads up.

OP, I think you might've lost more muscle this time. I carry weight similar to how you used to: at 207 I was a dress size 10 and pants12/14. Even now at 282 my pants are a size18 or XXL and my tops are L or XL. Size 18 dresses are baggy on me and I still wear size 16 dresses. It's always been attributed to the way I carry my weight (mostly butt, hips and legs) and mainly because I have a lot of muscle. If you're not already doing so, I think you might need to begin a light weight training routine. It will probably make you gain a few pounds at first but it's because you'll be converting fatty tissue to muscle and muscle weighs more than fat. I honestly think that's why we are told to maintain such high levels of Protein in the beginning - so that we don't lose so much muscle. It sounds like it's hard for people to meet that requirement; I haven't had my surgery yet so all I can do is guess... I hope your doc helps you figure things out!

Haven't had my surgery yet but so far things that I've purchased based on what I've gathered from other posts are: Gas X strips Pill box (the Monday through Sunday kind for all your vitamins) Pill cutter Heating pad (for the hospital and home) I'm sure others have more suggestions!

I totally understand the desire to have someone there with you. Don't worry - the hospitals will take good care of you. Leave your jewelry and anything expensive at home and they should be able to secure the rest of your stuff. Good luck both of you on your surgeries! I'm a praying woman so I'll say a prayer for you both!

During my consult with my surgeon he told me that he gives all his patients a little card that is signed by him with his contact information to present to any restaurant which states that the carrier of the card is authorized to order from the kids menu. He said he has had no one ever report back about being denied an item off the menu after showing that....

I had my psych evaluation today and at the end she said she had no red flags, I was a great candidate and she would send her summary to my doctor within 5 business days. Oh and that I am a mindless eater and she gave me literature on that. Good luck!