NurseJaci13

I'm at that very beginning of this process and I'm so confused. I spoke with my surgeon and they advised me that they would like me to call my insurance to get the specifics of my policy (I believe they do this as well, it's just a way for them to make us be aware of how our insurance works so we aren't surprised). Well, I called and I got one answer. It didn't seem right based on what I was seeing on here, so I called again...and then I got another answer. I spoke to someone in BRS, and they brought up the 6-month requirements that seem to no longer apply, but they are insisting they are (and sent me papers from 2017 to "prove' it). I reached out to my HR department asking for the specific language of my policy and they are being slow to reply (but I believe they are working on it). I have my first meeting with my nurse case manager tomorrow morning and I am curious what your experience with them has been? Are they able to see your specific policy language or do they just recycle what "they know" even if it's been updated? About me: 37, F, Iowa. BMI: 39.9 w/ severe arthritis for my age and hypertension. I'm 111 pounds over IBW. I'm not worried about getting approved eventually, I'm just trying to figure out if the 6-month thing is really something that is policy or not.

I'm going August 31st! So excited for you and I'll be following your journey

6 monthly diet visits (which if done correctly, can be completed in a little over 4 months...it's about timing...lol). I have United Healthcare Choice Plus, but it's an employer self-insured plan...which means my employer made the 6 months requirement a thing, not UHC (I think they have a more general policy). I say this because you may have the same insurance as someone else, but if you get your insurance through your employer, your policy may be vastly different.

Good luck! Focus on being comfy the next few weeks, both in and out of the hospital. When my mom had her sleeve done, she basically lived in lose sundresses for about a month.

I was pretty bummed at first when I figured out my surgery wouldn't be until the end of the year, but now...I secretly think it is a blessing. Hopefully, by then we have this sorted out...

Double-check if it is 6 months or 6 diet visits in different months. It may seem like splitting hairs, BUT...it can save a lot of time. For example, my first diet visit is tomorrow and my last visit is scheduled for the first week in November...a little over 4 months start to finish. It's a small loophole that surgeons/billing departments know about.

I've told my mother and a few close friends of my decision, and, at least on the surface, they've all been super supportive. My mom had the sleeve done 5 years ago and it very pleased with it, and another of my friends is going through the process right now as well (we call ourselves the "No Tummy Buddies" lol!). The two others I've told have said they are excited for me and hoping the process goes smoothly. I'm not planning on telling very many people, only those I trust and I spend a lot of time with so they aren't surprised by the change...I'm not ashamed, but I don't need unnecessary opinions from people who don't matter in my day-to-day life either.

So, I found out I can use the fact that I've been on WW for the last three-ish months to start "the clock" on my pre-op diet requirements...but, I'm concerned. I actually gained about 8 pounds during those three months making my BMI go up from below 40 to just over. It wasn't on purpose, and honestly, without WW I think I would have gained more due to the quarantine. My question is...will this make those three months "not count"? Especially since they are all virtual right now? Has anyone had any experience with this? Thanks for any advice! This site has been so affirming and helpful!

My doctor said over and over again in our informational meeting that diet and exercise alone have a less than 2% success rate for obese people, so he doesn't really have pre-surgery weight loss goals for us unless there is some kind of risk factor they are trying to minimize. I'm relatively "small" so I doubt that will be my issue. And, good luck to you too!!

I'm in nursing school! I'm set to graduate in 2022 (hopefully). Part of what finally got me to commit to surgery was going through clinicals and realizing how much my weight impeded me. I want to be the best nurse I can be . I wish you luck @WishMeSmaller and I pray for ALL of our sakes that COVID doesn't make this already frustrating process even worse.

As far as I can tell they don't really care if I gain or lose, at least from what my BRS nurse said. It's more about the "education" I receive. I'm more concerned that they will think I gained on purpose to get over 40, which I didn't. I also have to be over 40 or be over 35 and have co-morbidities @WishMeSmaller and I agree. I'm only 5' 3" so a pretty small weight gain or loss changes my BMI but 5-10 pounds doesn't really change my health issues. I don't think my doctor even cares that much. They want you to meet with a nutritionist twice before surgery and do two psych evals, but they don't have a minimum time to do it in. They will get you in as quickly as you meet those two requirements and insurance approves. I was just wondering if anyone else had this situation.

That's true; however, mine doesn't do that. I only have to meet with a nutritionist two times before they accept a patient. If insurance allows it, they will move forward in as little as six weeks.

Sending you lots of speedy prayers to get this approved ASAP. Let me know once you hear!

@KarmaNina I just got off the phone with my nurse and I discovered that part of the reason for the discrepancies is because my employer is self-insured, thus my policy isn't really a traditional health insurance policy. Chances are most of our policies are self-insured (something like 60% of large companies self-insure). As a result, my policy requirements are more strict. ugh! I also learned I have a lifetime max of...wait for it...$15,000.00! I know that it is after insurance discounts, so I'll probably be fine, but OMG! I work for one of the largest auto insurers in the US and they are CHEAP! Good to know I guess...I'll just keep letting them pay for my nursing degree so I can quit (honestly, they've paid $25,000 for an education I'll only use after I leave the company, but they limit the amount they'll pay for bariatric surgery?! Ridiculous!) I'm annoyed (maybe even a little bitter), but what can I do? I also found out that since I've been (virtually) going to WW for the last 3 months, I can count that towards my 6 months my employer requires as long as I see a nutritionist or physician twice in the next three months. EASY. DONE. OKAY. WILL DO. All this said, my BRS nurse was super nice and really seemed to want to help me get approved for surgery...no hate her way, just issues with my actual employer.

OMG! So excited for you! What a blessing that it went so smoothly and quickly! Sending so many prayers your way and I'm just so happy for you!! ❤️

Okay, good to know. In our educational meeting, my surgeon seemed to think most of us with UHC get through in less than 3 months (it's the most common insurance in my state)...usually, around 8 weeks, which is fine (the office makes us do some nutritional coaching, meet with a psych, and join a support group, so I'm good with taking a bit of time to get through that while I wait). Keep us posted!

Hi Matcha - This is the insurance I have as well, I have my first meeting with my nurse case manager later this week. I was wondering if you have heard back about your approval?