KyBandChick

Someone in my preop class asked about the gummi Vitamins and we were told we couldn't use them b/c you really can't chew them enough. I hear you though I don't like the chewables either

When is open enrollment for your insurance? I think most companies have theirs in November and new benefits begin Jan 1 of the next year. If you beneift year is Jan 1 - Dec 31 then you would be covered through 2009 so as long as you have the surgery this year you are fine.

I am doing great now but surgery was a day from hell for me. If was very nauseated in the hospital so they gave me Phenergan which totally knocked me out. My surgery was outpatient and we were not supposed to go home until after we used the bathroom. I was unable to go so they sent me home saying I should be able to go once home....nope didn't happen. So I called the doctor and he had me drive back to the hospital ER to be cathed. From entrance to exit I was in the ER 5 hours. Yesterday was a good day and the gas issues are getting better but they were really bad surgery day it hurt so bad to try and lay down to sleep. I know each day will be a bit later but I must admit I thought it was going to be a quicker recovery.

Many people go through the 6 month process once they have already found a doctor to perform the surgery. Have you been to a seminar yet? They are usually really good at walking you through the insurance hoops for the 6 month diet. Many doctors have templates to use with your PCP to help in getting all the information the insurance companies require. Good luck

One other thought. I can't tell where you live but are you sure the $30k is the best price in your area? That seems really high. I have seen several threads where people discussed price and my self pay (If I had to pay) was the higher cost of $17,500. Paybe attend a few seminars if you have't already as they are usually really good at helping with insurance and advice on self pay.

I would have to disagree with the above poster. It actually has a lot to do with your employer and the plan items they have chose to cover. I too have Aetna POSII and was covered for surgery tomorrow. I think you will find if you do enough research you will finds tons of people with this same insurance that cover and don't cover the surgery. The name of the policy doesn't mean everyone's coverage is the same. My employer is actually self insured and must use an insurance company to "front" their coverage. Look at your policy exclusions does it all out exclude weightloss surgery or does it exclude the surgery unless you meet certain requirements. My policy excluded the surgery unless it was approved by a Aetna director. See the below link to Aetna's policy for weightloss surgery. While your first answer my have been they don't cover the surgery sometimes they actually do they just don't tell you that part (you really have to read your exclusions that your HR department should be able to give you). Obesity Surgery Hope this helps. I have found the more research I did the more I learned about the game that is insurance approval. Don't give up. Is self pay via financing an option if you are not approved?

Do you know what your insurance covers regarding weightloss surgery? I would find that out first as it really has to do more with your insurance than the doctor. The doctor factor will be more so in network vs out of network. I am having my surgery on Wed with Dr. Lusco at St. Mary's & Elizabeth. I would suggest a seminar to find out more. I have been to Norton's and St. Mary's seminars and they are able to answer a lot of those type questions. Dr. Lusco's practice only in considered "in network" for one insurance and I think it is Humana (but not 100% sure). Take care, hope I was helpful.

You will probably get your instructions when you meet with the nutrionist. The length of the pre op diet varies with each doctor. I think if you read enough you will find some people have no pre-op, some only have a few days and some have two weeks or more. My doctor has me on a 1 week diet

Welcome!! I too am being banded on the 21st. The liquid diet is tough I thought the crave for yummy food would get easier as the week goes by but it hasn't. Nothing I can't manage but boy I sure am hungry for something solid and filling. Best of luck to you.

I am on my pre op diet now too. My doc only makes us do the diet for 7 days. My diet allows a bit more than shakes as I can have a little cottage cheese, lite yogurt or SF pudding. Plus 2 small pieces of fruit and 2 cups raw veggies and 1 c. juice. Are you eating the egg your doc said you can have if needed? If you eat something normal you are just going to want to eat something normal again. The diet isn't so much about losing weight in general it is about reducing the type of nutrients that collect in your liver so a result your liver shrinks and weight loss is a bonus. You have made it this far you can go the rest of the way. This new journey in your life is about sticking to things you haven't stuck to in the past (think of this as one of those milestones).

I am on day 4 of 7 of my pre op diet and have lost 4-6lbs (my scale is not very consistant). My doctor said his people usually lose 8-12lbs. I am also due to have my period anytime so I am hoping that is part of it. I seem to lose weight at a snails pace so I don't know why I am surprised. Good luck to you with your surgery.

I guess my pre-op diet could be worse but I sure would like something real to eat. I can have 2 small pieces of fruit and 2 cups of raw veggies then yogurt, cottage cheese and pudding in addition to 2 shakes. I can't wait for Wed!!!

Hey Maybell, I have my surgery Jan 21st with Dr. Lusco. I have been reading through this thread and enjoyed your posts as I am going through many of the same things since we go to the same surgery office. I am on day 2 of the pre-op diet and I am hungary but not too bad I just really want warm things. Sounds like the Aleve pain meds are not enough did you fill the perscription they gave your for Celebrex? Good luck to you, I'll be looking for your updates

$450 is crazy high and appears to be very deceiving. Have you called your doctor asking why they missed the charge by so much and why are they just now figuring it out to where they have to back bill you (sounds fishy to me). I get free adjustments the first year, then 3 free fills after that then they are $75 a fill or $50 an office visit. Do you have any documentation from your seminars before surgery where prices were discussed?

I am having surgery Jan 21st. I was out last Friday for about 4 hours. When I got back to work a director (not my boss) gave me grief for being out b/c they needed me to answer a question. I just told him I was at the hospital for the past 4 hours having some diagnostic testing and that I wasn't out having fun. I could tell he felt bad so he left me alone the remainder of the day. I currently have no plans to share with my co-workers that I have the band as I too am pretty private with my weight issues. Since the loss isn't as fast as gastric I plan to pass it off as normal weightloss unless I decide different later. I thought about saying gall bladder too but I am only going to be out 3 days so I am going to pass it off as vacation.

kteggers - I agree with the earlier post on your negativity. I too have a lot of weight to lose and often get scared wondering if I can do it. Throughout this process I have decided I have to have a positive "Yes I can" attitude. My surgery is the 21st and I too am scared with "Can I do it?" "Will I be able to take off all this weight (seeing as I have so much to lose)?" I have decided I have no choice, failure isn't an option as I owe this to myself. I think of all the wonderful things in life that have passed be by while I stayed home "fat" and realize the only person who can give me those things is myself. You can sabatage your diet with the band so you have to tell yourself that you aren't going to let that happen (not this time). Having surgery to help with weightloss is a drastic step that you can't treat like every other diet in the past. Just b/c you failed before doesn't mean you have to fail now this is a new opportunity. You owe it to yourself!! Best of luck keep us posted. This site is great for encouragement.

I am scheduled to be banded on the 21st as well. It is interesting how each surgeon is different on their pre op diets. I don't start mine until this coming Wed (7 day diet). My diet is a mix of low carb shakes (2 a day) a cup of juice, 2 servings of fruit, 2 c. raw veggies, 3 dairy (SF yogurt, cottage cheese or pudding) and all the broth, SF popsicles, diet soda etc. I was never nervous before but now I am beginning to be.

I have Aetna and did the 3 month multi diet. The hospital where my surgery is performed offered the program as part of my surgery fee. The 3 month process was really easy. Once a month I met with the nutritionist who 1 month just had me try and change a few habits then the next month had me write down everything I ate then nothing new the third month. After each visit with the nutrionist I went and met with the hospital exercise physiologist where they weighed me and reviewed my exercise journal which was all submitted to my insurance. I also did the psych evaluation (which was a joke).

When it comes to insurance it really has nothing to do with your plan name and everything to do with what your company is willing to pay and how they have set up their plan. I have different out of pocket max for in network and out of network ($2500 in and $7500 out). I am going to an out of network Dr but my surgeon office told me only their fee ($4,000) is considered out of network (as he only accepts 1 insurance company) and the hospital fee is in network so I get 50% of the Dr fee and 80% of the hospital.

My program gives you 6 wks with the hospital's trainers for 6wks with your surgery cost and you begin your exercise 1 wk after surgery.

Read your benefit book. My insurance out of pocket max does not include my co-pay or deductible and the amount for the max is for the individual or the family. I too have Aetna and my benefit book is pretty clear. If your surgery were lets say $15,000 then your would subtract your deductible (15,000 - 1,100)=13,900*0.2=$2,780+1,100=$3,780 out of pocket cost. If the surgery cost were higher you shouldn't have to pay more than $4,000. I am not an expert but I believe that is how it works.

I am scheduled for Jan 21st in Louisville, KY! Did my preop work today then start a 7 day liquid next wednesday. I was never really nervous before but I am starting to be now as it is all starting to be so real.

I am scheduled for January 21st!!! I can't believe I finally have a date. I go Friday for my pre op testing so I guess I will be told then about my pre op diet.

Could you finance the cost of the surgery? I know my Dr offers a financing company for self pay people where you can make payments? You have to be careful with insurance b/c the insurance company isn't really the key it is more so what your employer is willing to pay for in their plan. You could easily find that Aetna will pay at one employer and not at another it's all in what your company pays for.

My insurance is requiring either a 6mo diet or a 3 month multi-disciplinary program. I am going wit the 3 months. But I think the reality of the requirement really comes down to money. With the diet requirements if 10 people start the process then probably at least 5 will not follow through with the program so then they saved the cost of surgery for 5 people. Insurance always comes down to money.