RNY-Gal

Update since last posting... I got the OK from the insurance company! I'm a candidate for WLS. I had my surgeon meeting this past Monday. He was so nice and excited to get this started. I have my first NUT appointment March 3rd, Pulmonary test March 15, Endoscope April 22nd. It's starting to feel real now!

I have it through my employer. They recently just got this insurance (December 2015 UPMC) and my HR really don't know anything about it(go figure) she was actually trying to talk people out of getting it as she said "it's not worth it" but for me it is because it's the only insurance I've had in years that actually cover bariatric surgery. Now I found another part of my policy that contradicts the other section which I posted. Then here is the other part where I original got my information about what is required.

Let me know what you guys think of this. I have a BMI of 52.4 looks where it was say 45-55 BMI from what I get from it is I need either have one co-morbidity OR Do the 6 month diet. So now I'm told that isn't right. And that I need to have a co-morbidity AND do the 6 month

I just spoke to my insurance company and the lady agreed with me it's either OR, not both. But she said she wanted to look into further and she was going to get back to me on it. She thinks the person my coordinator spoke to read the wrong one. Because there is different sections for different patients. People under 18, over 18 and revisions. So, I don't know what to do now. My coordinator cancelled my Nut. Appointment. So if it comes back I was right the whole time I'll be a month behind. And won't see a surgery until August or September. :/

It is so frustrating.. My coordinator also pointed out that's how she she saw it too. But the insurance company said no, that the policy wasn't correct.

Well, I just got a call and it was a crushing blow. I guess my policy is worded wrong and now I don't qualify. I don't have any co-morbidities. I have high blood pressure but you have to take three forms of medicine for that to qualify. So, my appt. with my Nut. Was cancelled. But she kept the one with the surgeon. She wants me to get a sleep apnea test and hope for a positive. I'm pretty discouraged right now. This sucks!!

April is so close! Hopefully you can get it done in April. At my rate it looks like I maybe a July or August surgery. Sometime this week my coordinator is supposed to call with my appt dates. I'm getting very impatient lol. I started all this back in December. But had to wait for seminar which wasn't until late January. I have UPMC luckily with that insurance I just have to do a 6 month supervised diet, NUT/support group classes each month. (Due to a high BMI) Along with physic eval, labs, ABG pulmonary test, upper GI X-ray, and endoscope. My coordinator said she can get three of the tests scheduled and done in one day! Which is great... I also have to lose 5-10% weight in these 6 months

Sweet! Where abouts are you located and how far are you into your journey to WLS?

I'm near Hermitage PA. Also, I will be getting Gastric bypass. Even though lately I have been leaning towards the sleeve. But, I read and heard it you get bad GERD with that.

I'm an hour north of Pitts. I'm at the beginning stages of the whole process. I had my seminar on Jan 27. The coordinator said she will start calling people in two weeks. So hopefully I get my first appt next week to get the ball really rolling.

I have a question about the 6 months diet. For my insurance it says weight loss, stable weight but no weight gain. Does this mean i can't gain no weight in 6 months? Or, I can't gain weight over my starting weight? I don't meet with my NUT for the first time in a couple weeks so I can't ask her.

Hello, I'm 31 female 5'8 with a BMI of 50. My insurance company covers surgery. But I don't know what to do to start the whole process. My IC requires a 6 month program. I got a referral from my PCP for gastric bypass. I called the surgeon, but the nurse set me up with a free information session. She was going to send me a packet in the mail about it. I called them on Dec16, 2015. The free information session isn't until Jan, 27th 2016. It just seems like a very long wait just for a information session. That month could be used to start my 6 months of lifestyle changing program. So really my question is, am I going down the right road here or is there any shortcuts to get me going faster? I have UPMC insurance.

This is very informative.. Yeah, my information session is the required first step. So I really can't start anything until I do that. Two more weeks to go! I actually can't wait until I really get started I've been waiting for this to happen for YEARS!!

100% coverage after I pay 1,500 deductible upfront.

I go to my information session on the 27th. Sucks it's long wait iceberg waiting since December 16 just to go to the information session. I filled out all the paper work for the surgeon hopefully soon after the 27th I can start my 6 month pre-op diet and requirement appts. Watch a lot of YouTube videos.. That's what I did.

North of Pittsburgh in Mercer county. I just started my journey. I haven't even been to the free seminar yet(apt date Jan, 27th. I did fill out the forms I got in the mail the other day. I will be seeing Dr. Christopher Myers. I will be getting RNY.

Well, I decided to go to my insurance website to read about everything, and I found something I didn't see before. http://www.upmc.com/Services/bariatrics/approach/Pages/default.aspx It seems that it's the first step. So I have to do it.