paisleypea

I have BCBS and they ARE paying. it all depends on your policy. Some employers cover bariatric surgery and some do not. I am lucky in that ours does.

I have found they are all different. My surgeon requires an initial consult with the nutritionist at $50 and then a 5-hour class with her that cost $150. I thought it was overkill when others didn't charge that, but.........then I found out it could have been a LOT worse and I really liked my surgeon. I figured if I was getting it covered by insurance, that was kind of like my "co-pay"

She needs to find out what Kaiser says. most have their medical policies on line. Blue Cross has it all spelled out so I knew what I needed to qualify. typically it takes a BMI of 40 or greater, OR a BMI of 35 with 2 co-morbidities

When I talked with my Primary Care Physician, I explained that I was borderline in my 5-year history of being over BMI of 35 (I have 2 co-morbidities) and was just sick that after being where I am, and a history of it just going up and up and up, that I'd get stuck with some weights in my record just shy of the BMI I needed. he said, well ---- let's re-measure your height and see if it is correct. To be fair ---- my records had heights listed within 2 inches ---- all from different people measuring. I bent my knees a bit and he did not look down at all. I ended up making it! He had all my heights re-listed in the records even. I felt he was a gift from God! I'd lost 23 pounds on my 6-month diet and was under the BMI, so I did gain back 7 of the pounds and I did carry a roll of BB's in my pocket too - One pocket had bb's the other had rolls of quarters. just to be sure. I've not had to be weighed since ------ and I just keep losing (or trying to lose). Do what you need to do. My dr. said to me, "we know you need the surgery and a little technicality isn't helping. The surgery will help your health."

Wow! It amazes me how it is different for each surgeon. My story --- right off the bat had to do that 6-month dr. supervised diet, which the first surgeon's office I called said I had to do with my own Primary Care Physician (PCP). I hadn't even gone to a seminar yet! ugh! but I did quiz 2 people one-on-one who each had the band previously one year and two years. That was Sept. 2008 Then I decided that surgeon wasn't good, and she'd left the city anyway. While on the 6-month thing I'd been researching WHO I wanted to interview and such. I made an appt in April 2008 and saw the surgeon within a week or two. My husband came with me and it was just us and him. that was awesome! I got the impression it would be "fast" from that point - ha! I did have the "hard" part done - the 6-month diet, and the same day we met with the surgeon we met with the dietician (for an extra cost of $50) but then I had to go to a nutritional seminar (5 hours on a Sunday! and it cost $150), and have the psych eval done. I thought it'd be fast to turn in to the insurance then, April 21st, but no.........turns out that I'm not that high of a priority so if I wasn't calling to check on my records, they weren't looking at them either. I know it seemed like an eternity at the time ---- but an extra month when I was READY TO GO did seem like an eternity to me. They finally got my records sent to the insurance on May 15 (I had it all done by April 21! so frustrating) I called the insurance company on May 22 - even though the surgeon's office pre-certification lady told me it would be a minimum of 10 business days --- and to wait for her to contact me. They had approved me on May 20! I was SO HAPPY! May 20th was my birthday! how awesome is that? I immediately called to get on the schedule and the first opening was June 15th. So ---- from the first time I spoke with my PCP was the end of Sept and surgery (hopefully it sticks for a date) of June 15 ----- almost 9 months. seems like a long time doesn't it? oh - I didn't get the insurance letter in the snail mail until May 29th and I don't know WHEN the surgeon's office got it. That lady kept telling me to fax her mine, but I don't have fax so I tried scanning and emailing. it was a mess. it is time consuming for sure, but makes it all that much more sweet ---- you know you want it and appreciate it.

Yay to you for being thru the surgery! Glad to hear ya'll are back to work too. keep doing well and sip! sip! sip!

Yay! Glad it went well. bummer you had to drive so far and be sore. My surgeon wants me to stay overnight just cuz I'm from "far away" [colo springs instead of south denver area ---- but it's only an hour!]

I can't answer your question, but wanted to say YAY! you got your surgery done and your are on the road to recovery and the journey! :-)

oh, THAT is such a bummer! so sorry to hear about the devastating phone call. I am worried about that with my EKG thing too cuz my pre-op work is just the Friday before the Monday surgery. Do you HAVE a cardiologist? do you normally have an abnormal EKG? I'll pray you get fast clearance and your same surgery date! i have something abnormal in my EKG, the first one I ever had showed it. then I had it checked twice more while on phentermine earlier this year. i think I will ask for those EKG results and diagnosis and take WITH me so I don't get declined right then too.

I would even consider turning him ---- state medical board??? ---- because that isn't right ---- charging money upfront for what insurance pays for anyway. I have BCBS and the surgeon who is one of their Preferred Providers must take the allowed amount and cannot bill me for more. it's in their contract!

I've seen mention of this tool and wondering if I *need* it??? Is it used mostly for smoothies? I have a Vita-Mix and it's super easy to use and to clean ----- do I really need a Magic Bullet? thanks for your help

Wahoo! That is awesome

I echo what everyone else has said ----- RUN to another surgeon. I too have BCBS and they would only pay for it if it was with a surgeon who was rated by them and in a Center of Excellence. They are serious about wanting good surgeons for their money.

me too - I am June 15th

Thank you so much for all your feedback everyone! HappyHomeCC - I laughed right out loud when I read your note too ---- the KickA$$ blender. :smile: It is da bomb for sure. Us too - thick smoothies. Hey - you and I go in for pre-op work ups on the same day - June 12th. My surgery is for Monday June 15th.

Thank you all for your stories. I too am a low BMI-er (35) but like lots of you ---- lost and gained so many times. To the point I refused to "try another diet" becuz they are all the same - start great, lose, then gain back. ugh! Happy to hear the "down the road I am happy I did it" encouragement! I have the band put on/in June 15 and looking forward to being FULL. gosh - I can't wait to not think about food all the time!

Wow - I had never thought it would require that much change either! My husband is so cute and is taking the following day(s) off/work from home to help out. Basically - running the kids around so I can sleep. LOL My pre-op classes didn't mention that much change either - sore a few days etc. Gemini ---- I gave natural birth twice and thinking, if we can handle THAT, we'll be fine! I gave birth naturally and took the pain pills after ---- which is similar to this!

Here are some other adjectives I found in my dictionary juba |ˈjoōbə| noun a dance originating among plantation slaves in the southern U.S., featuring rhythmic handclapping and slapping of the thighs. ORIGIN late 19th cent.: of unknown origin. CUZ WE ARE BEING SET FREE FROM OUR SLAVERY TO FOOD! ------------------------------------- jubilant |ˈjoōbələnt| adjective feeling or expressing great happiness and triumph. ----------------------------- jubilee |ˈjoōbəˌlē; ˌjoōbəˈlē| noun a special anniversary of an event, esp. one celebrating twenty-five or fifty years of a reign or activity : [as adj. ] jubilee celebrations. • Judaism (in Jewish history) a year of emancipation and restoration, celebrated every fifty years. • (in full Jubilee Year) a period of remission from the penal consequences of sin, granted by the Roman Catholic Church under certain conditions for a year, usually at intervals of twenty-five years. -------------------------------- jump to it! informal used to exhort someone to prompt or immediate action. -------------------- jaunty |ˈjôntē| adjective ( -tier, -tiest) having or expressing a lively, cheerful, and self-confident manner : there was no mistaking that jaunty walk. ------------------------------ jaw-dropping adjective informal amazing : jaw-dropping displays of genius. --------------------------- jazz |jaz| noun a type of music of black American origin characterized by improvisation, syncopation, and usually a regular orforceful rhythm, emerging at the beginning of the 20th century. Brass and woodwind instruments and piano areparticularly associated with jazz, although guitar and occasionally violin are also used; styles include Dixieland,swing, bebop, and free jazz. • informal enthusiastic or lively talk, esp. when considered exaggerated or insincere : all this jazz about how they can't afford it is preposterous. ------------------------ jewel |ˈjoōəl| noun a precious stone, typically a single crystal or a piece of a hard lustrous or translucent mineral, cut into shape with flatfacets or smoothed and polished for use as an ornament. • (usu. jewels) an ornament or piece of jewelry containing such a stone or stones. • a hard precious stone used as a bearing in a watch, compass, or other device. • a very pleasing or valued person or thing; a very fine example : she was a jewel of a nurse. ----------------------------------- jockey |ˈjäkē| noun ( pl. -eys) a person who rides in horse races, esp. as a profession. • an enthusiast or participant in a specified activity : a car jockey. verb ( -eys, -eyed) [ intrans. ] struggle by every available means to gain or achieve something : both men will be jockeying for the two top jobs. • [ trans. ] handle or manipulate (someone or something) in a skillful manner : Jason jockeyed his machine into a dive. ------------------------------------------ joined-up adjective chiefly Brit. (of handwriting) written with the characters joined; cursive. • (especially of a policy) characterized by coordination and coherence of thought; integrated : a joined-up approach to rural poverty, public services, and employment. ------------------------------ Jailbreak joined So maybe we can be the JOINED-UP JUNE JOCKEYS or JOINED-UP JAUNTY JUNE JOCKEYS

I brought it up with my PCP a couple/three years ago and he said I couldn't do it because 1) wasn't big enough, 2) no co-morbidities. and besides that I'd be right back there again afterwards unless I figured out WHY I was fat to begin with. I started up with a counselor (who was WORTHLESS! I did not need behavior modification - I needed my head to know why I went to food to begin with! grrrrr) anyway - i switched doctors and decided this fall to bring it up. i'd been researching it and asking someone who had it all about it. He was super supportive and wrote me out a referral right then. Unfortunately - the local surgeon he referred me to required the 6-month dr. supervised diet to be with PCP not the surgeon's office. So - back to PCP and 6 months - with drugs. Long story - but I'm going with an out-of-town surgeon, highly rated, and am on board for surgery in June. hooray! my two cents - if you research this and look into it and the PCP doesn't support you ------ find another one!

I echo the thoughts here too! I have a BMI of 35 and both my PCP and the surgeon were VERY supportive of my wanting to do WLS. Other "friends" that know have of course said, "oh you don't need it" blah blah blah. you know ---- I have been obese my whole life! even into that morbidly obese category. I can LOSE weight when I want to - it is KEEPING it off that I struggle with. So excited that I made the decision AND my insurance approved it. I have a couple of co-morbidities (high cholesterol, high blood pressure). Isn't that the rub though --- when I looked into it a few years ago I was told I wasn't 'obese enough' for it! I changed doctors by the way. LOL