Michael1127

Has anyone had any experience with Highmark Blue Cross Blue Shield Delaware in the approval/denial stage? I'm not at the submission stage yet -- I will be in October 2016 -- but I would like to know if anyone else has any experience. Thanks in advance!

Good morning, everyone. I just joined this forum so I could have a great support system in place besides family for when I finally get my surgery. Greetings from hot and humid Southeastern Pennsylvania! A few facts about me... I've always been heavy and big. I used to write it off as being "big-boned" but as I grew older I became heavier and heavier. Now I am 45 with a BMI of almost 50, I'm diabetic, and I have high blood pressure. My health got way out of control for me, so I started eating better and cleaner and investigated bariatric surgery. Ultimately I decided to have a gastric sleeve done at the Hospital of the University of Pennsylvania because I get my primary and specialty care there. In fact, one year ago today I attended my first bariatric surgery info session. My surgeon will be Dr. Noel Williams. I started the medical weight management process in October 2015 and sort of chickened out. Then I changed jobs and got new insurance and decided I needed to do this for myself and my family, including my two little girls, so I had to go through all of it again starting in April. My current insurance (Highmark Delaware) requires 6 sessions and I just completed session #4. In the interim, I've had a chest X-ray, upper GI series, psychological clearance, cardiac clearance, pulmonary workup sleep study is next month), and endoscopy. I'm ready to have it done but yesterday my surgeon and I decided to aim for February 2017 because that will be the one-year anniversary of my new job, thus making me eligible for FMLA. I have a question about time out of work - I've read the FAQ, but would be interested to learn your perspectives: I've read anywhere between 2-6 weeks out of work. I had a friend who had a duodenal switch done and she was back within 2 weeks, which included 1 week in the hospital recovering. I, like her, have a sedentary/desk job which doesn't require any significant lifting. Is 2 weeks post-discharge from the hospital a realistic timeframe to aim for in a return to work? I'm nervous as heck about this surgery but also eager to get it done because I know it's going to totally change my life!

Thanks for the perspective and information! I am very impressed with the Penn bariatric program. They're really committed to making it work for the patient. I think I am going to apply for 3 weeks of FMLA leave and see how it goes. Fortunately I am eligible for short term disability now so I'll get some income ... I'm salaried so I don't really have PTO or set vacation days. I'm planning ahead now because February will be here before I know it! i'm going to my first support group at Valley Forge later this month and plan to go to as many as I can post-surgery.