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Everything posted by Nightshade
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So, I originally spoke to my PCP about seeing a dietician or nutritionist 4 years ago when my weight started to really be an issue. At that time they kept giving me the run around and saying that they couldn't get an appointment or that they didn't have room for new paitents, ect. So I waited. For two years. While struggling on my own to figure out why I kept gaining weight. Now, at my highest weight previous to losing control of everything, I was 19 years old and about to give birth to my daughter. I weighed in at a whopping 133 lbs. By the time I asked to see a dietician for the first time I was 180ish. Two years of not knowing why I kept gaining weight, and trying everything the internet could throw at me, I was 210 lbs. And absolutely miserable. I was wearing size 14 and was tired all the time... It was just the pits. Last year I had finally had enough and cried while I begged my PCP for a referral for surgery. I was 260 lbs and had a hard time playing with my kids. My PCP tells me I won't qualify but puts the referral in anyway. After meeting with the surgeon, I was told my thyroid level was way off and they started me on synthroid. I was also started on metformin because I am apparently prediabetic. Been doing monthly appointments, my next is Friday and thats my 4th, and have 6 month requirement. Got my psych clearance. Have to attend a fitness class and a support group but just those hoops and my last few appointments... And I'm starting to get really excited and nervous. I've cut soda out, except for a slip the other day when I did a 22 hour shift... Immediately bought non carbonated caffeine by the case to keep at work in case that happens again. But.. I've gotten down to 235 and I'm so happy. I am honest about my intentions for surgery with everyone. Coworkers, neighbors, friends, family... And most people try to tell me "You're not fat enough for that." And "If you do that you'll lose a whole person, do you really want to be that skinny? You'll look sick." And I'm just like, "I look sick now. I am sick now." It's not only about looks. It's about being able to do the girls on the run 5k with my daughter, and running during baseball practice with my son. It's about feeling good. And yes, I am excited to be able to fit smaller clothes again, but until a few years ago I was an effortless size 4. So sue me that I mourn the me that could wear a slinky little dress and feel good about it. I don't feel good now, but I'm working on that. Isn't that what it's all about? Feeling good about yourself and what you do? About who you are? Anyway. I'm super excited watching those numbers drop. Being able to put down the size 22 jeans and go back to an 18 or 20. I am excited to finalize this change with the sleeve and really get down to a healthy weight again. To know I'm not going to die because I walked up the damned stairs and can't breathe. I don't post much.. But juat couldn't hold that in anymore.
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Looking for people in the beginning stages.
Nightshade replied to LoveLife4U's topic in PRE-Operation Weight Loss Surgery Q&A
Hi. I'm 28 and fairly new as well. I've done my group consult with dietitian and nutritionist, had my first and second appointments with psych and gotten all my lab work done. Have my second appointment with nut on monday. Completed 2nd appt with dietitian this week, but screwed up and didn't fast because it was scheduled for afternoon instead of morning. Have to do this thing where they test your resting metobolic rate. So much still left to do, as my surgeon requires fitness classes and support groups. Insurance requires 6 consecutive dietitian appointments, and at least 3 nutritionist appointments. I'm trying to wait until mid June to do the support groups and classes as they're all in the evening, and during school I can't take a weekday evening off, with 3 kids my school night evenings are packed and I can't get away. Hopefully I can get all my requirements done by September, and I'd like to try and schedule for mid October or early November. My BMI is on the lower end, at 37.1, but I just learned I am pre diabetic, so hopefully that'll help with insurance coverage. Anyway... Good luck everyone. Sent from my LGLS775 using BariatricPal mobile app -
Okay. So first thing is I have Aetna better health premier insurance out of Michigan. It is a Medicaid/Medicare dual enrollment plan that I've never had issues with before. Prior to receiving my referral to Bronson Methodist hospital two years ago I haf called my insurance and asked about covered services. I was told they'd cover everything as my BMI was over 40. After working for 7 months to complete paperwork and go to the required before initial appointment but always full seminar, the surgeon left and I had to start over at Borgess Surgical in Kalamazoo. Now I'm finally on to month 1 of my 6 medical weight loss appointments, and the surgeon requires a checklist to be completed and at least 2 nutritionist appointments. At my first appointment the office made me sign a waiver. Stating that i understood my insurance may not cover the 400 dollar group session, which doesn't count towards. my at least 2 appointments with that employee. I've since called my insurance and had to be transferred four times in order to be told that person has to make a bunch of calls and then would call me back. Has anyone else had any similar issues? How was it resolved? And does anyone have Aetna better health? Did you have any unexpected bills? Was the approval process difficult? Thank you.
- 8 replies
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- aetna
- medicare/medicaid
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(and 2 more)
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First problem, required but not covered?
Nightshade replied to Nightshade's topic in Insurance & Financing
No deductibles, card even says "Paitent cannot be billed" right on it. Sent from my LGLS775 using BariatricPal mobile app -
First problem, required but not covered?
Nightshade replied to Nightshade's topic in Insurance & Financing
I did contact my case manager, but honestly, she doesn't seem to know what she's doing. I've had issues with her since she started. But she says they are filing for prior authorization and that she thinks it should go through. Thank you for the verification that i was doing the right thing. It's taken so long just to get to this point I'd rather not have any other issues. Good luck with yours, i hope everything goes through smoothly. Sent from my LGLS775 using BariatricPal mobile app