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Unbelievable. Cigna cannot determine whether weight loss surgery is covered or not under my insurance policy. On the phone, I have been told yes, it is covered only be told later that there is a a specific exclusion in my policy for weight loss surgery. I was ready to self pay. I saw the surgeon this week for an initial consult and tentatively scheduled surgery for the first week in November. BUT the bariatric coordinator just called - Cigna called her and said they thought WLS is covered under my policy. The bariatric coordinator let them know that Cigna said it is not covered when she verified my benefits. So the Cigna rep is "double checking" and will get back to her. I can't believe this! How difficult is it to determine whether I'm covered or not. Has anyone experienced this type of thing before? Also, if a miracle happens and I am covered, what kind of hoops will I have to jump through with Cigna? Any experiences with Cigna in this regard would be much appreciated. Thanks in advance!
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I prefer protein powder over ready-to-drink shakes, and powder tends to be less expensive. My favorite brand of protein powder is Ideal Lean, but it is really a matter of personal taste. For ready-to-drink shakes, Equate brand is pretty much the same as Premier Protein but priced much lower. I am almost 2 years out now and I no longer drink protein shakes. I get plenty of protein from food, and I'd rather eat food than drink a protein shake. It is really important to budget for what you'll need post-op, and don't forget about vitamins. The best value in bariatric vitamins is the BariatricPal brand multivitamin, which is $99.99/year for a subscription (I recommend you buy a smaller bottle first and make sure you like them before you subscribe; also, you'll probably need chewables for the first few months after surgery). Depending on your program/bloodwork, you may need additional vitamins (I take calcium, chelated iron, vitamin B-12, vitamin D, and biotin in addition to the multivitamin, and I also use pre-workout and essential amino acid supplements). Vitamins are super important for gastric bypass patients, so you have to make sure you're prepared to buy them before you have the surgery. In the early post-op stages, I was eating so little that the costs balanced out. Now that I'm eating regular food and larger portions, though, I am spending a lot more on food than I was before surgery, even though I'm eating less. I used to shop sales and buy cheap food. Things like chips, crackers, cookies, candy, frozen meals and snacks, baking ingredients (sugar, flour, oil, butter), etc., can be very inexpensive when you buy them on sale. Now, I buy a lot of fresh produce, meat, fish, herbs, and spices, plus some healthier substitutions (sugar-free sweeteners, protein bars, low-calorie salad dressing, sugar-free condiments, olive/avocado oil, coconut flour, etc.) and prioritize health and taste over price. I'm sure I could spend less and still eat healthy if I really needed to, but I have invested so much into this surgery and losing weight that I'm willing to spend more money on food that helps me stick to my plan.
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Lets see if I got this correct: you do not have a fill at this time and you were unfilled due to swelling? From what I understand being totally unfilled is much the same as not being banded. If I were in your shoes it would be very easy for me to regain all that lost weight. Don't be down on yourself for that! I am a binge eater. I can always be good during day time, but then the monster is unleashed towards afternoon evening. I can't get full. I eat all the wrong foods because I get discouraged, knowing there is no control. An addiction that I felt powerless over. I know the eating is emotional, but there is a physical componant to it. That hunger, that obession with food, when will I eat again? What will I eat? Then the loathing myself when I overate. The fear that I was going to eventually die from this......I felt lost. So I had the surgery and after the initial restriction, I realized I was back to my old habits again. I had my surgery June 24th. I had 4 fills and honestly other then not being able to take big bites I felt little difference then I did pre-surgery. I got stuck once with chicken and so I was very careful to chew my food. I'm sure this helped me eat less, but NOT a lot less. I didn't have the totally unabashed cravings as in the past but fairly close and certainly was eating too much to loose weight. And I was trying, really trying. I wore my bodybugg, I decided to diet. Again good during the day and then night came and I would blow it. I will admit there was more control but still I was obsessed with food. I maintained my loss, but just. I would loose 5 lbs, binge eat (with the band and 4 fills) and gain the 5 lbs back. Then last Monday a miracle occured. I got my 5th fill. And walla, like magic, or rather for me a miracle I no longer have cravings. Its weird......I tell you weird. I am very emotional about this because I didn't think this was possible for me. I also had begun wondering if the band would do anything for me. Having fought food my entire life. For the absolute first time I do not think about food 24/7, I am not hungry. I eat for nutrition. I NEVER could understand people who could do this. My mind just did not work this way and I didn't think it was possible. I am eating 3 SMALL meals a day w/o snacks and feeling happy and satisfied. I have no desire to binge. I do not feel hungry. Strange for me, exhilerating and for the first time in 10 years I have hope of being healthy and "normal". HOPE is a big thing when you have lost it. Please don't give up. Call your bariatric team. They will know what to say to you. Do you have a support group? If you do go to the meetings. Find a mentor. I hope this helped. 2 weeks ago I felt much like you described. I knew I was on my way to regaining all of my weight. Today I'm buzzing with excitment for my future......there is a joy that is hard to describe. I have control over this hideous monstor. You will get there! :thumbup:
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How to decide on best surgery
Berry78 replied to fastfoodaddictnomore's topic in Duodenal Switch Surgery Forum
Do you currently have gerd or frequent heartburn? Do you have access to bariatric care closer to home if there were a complication? If so, what procedures do they perform? How keen are you in taking daily supplementation? (Vitamins) How enthusiastic is your primary care physician to take care of you after surgery in Mexico? -
Researching Mexican Lap-Band Doctors 101
faithmd replied to WASaBubbleButt's topic in Weight Loss Surgeons & Hospitals
This is a great thread you two. And just an FYI for you, Lauren: At the ASBS convention this past June (when they released the AP band) there was a presentation about the post-op diet and guidelines for revision to allow softs to solids much earlier than before. I notice that Allergan hasn't changed their reccs on their website yet, but I found it interesting that someone would present to a group of bariatric surgeons that it is okay to eat earlier. Perhaps your doc had read the latest from the convention and that is what made her put less emphasis on the post-op diet. I have to wonder though if part of the reason for the change in diet comes from patients complaining and griping about being hungry so much. And/or if the change was intended for AP band patients only. But thinking logically about the stomach and it's action to digest, I can't imagine that speeding up the post-op diet would be fine and dandy. But I'm not a surgeon and I'm not a bariatric researcher. Of course, one can always go slower on their post-op stages themselves. -
15-year-old with a BMI about 40. ESG
lizonaplane replied to Jon1rene's topic in Endoscopic Sleeve Gastroplasty Forum
I know that I wouldn't have been ready to do the surgery when I was a teen, but that doesn't mean that he isn't. But it's a lot of work. Here is an article about teens having bariatric surgery from the New York Times: https://www.nytimes.com/2017/02/24/health/obese-teenagers-bariatric-surgery.html If you can't access it, let me know and I will try to summarize. There are also medications that can help that could see if he's ready... but he'd have to be compliant with the medications, and in order for them to work, you have to eat less, so if he has bingeing issues, it won't help. It is certainly better to have surgery when you're younger and don't already have co-morbidities, but you have to be mature enough to change your eating habits, which can be hard if all your friends are stuffing their faces with junk food. Good luck! -
Online therapy for eating disorders
ShoppGirl replied to Tomo's topic in Post-op Diets and Questions
Does anyone know a good bariatric therapist anywhere in florida who may be willing to do telehealth appointments? I found one person so far and after two appointments I don’t feel like she is the right fit for me. Apparently they are few and far between in my area but I’m thinking post COVID maybe telehealth will work (someone said they have to be in the same state to bill insurance). -
How many carbs are you allotted per day? Who prescribed that amount? My doc only asked that I focus on grams of protein (60), which is a modest #, based on what I've seen others post here. I highly recommend the book called "Proteinaholic" by (bariatric surgeon) Dr. Garth Davis. Dr. Davis is also very active on his FB page and happy to answer questions there. "A Pound of Cure" by (bariatric surgeon) Dr. Matthew Weiner is a good read, too. Dr. Weiner also has many lectures available on Youtube.
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Bariatric Advantage, Where Is My Stuff?
Gigi_Girl replied to monki's topic in Protein, Vitamins, and Supplements
Can you track your package? I use Bariatric Advantage multi Vitamins, calcium, and Iron, but I order thru Diet Direct. They have good quantity discounts and free shipping for orders over $49. Their shipment usually arrive in a few days. -
petag21, I know this won't help you over the weekend, but on Monday morning, I want you to go and get your insurance card, then go to your telephone and call your insurance company. Tell them you want to have adjustable gastric banding done and ask if they have a special procedures case manager who takes care of the bariatric cases that you can speak with. If not, then speak to whoever can help you figure out if they cover it and if so, what the requirements are. Have a pen and a pad of paper handy, write down the name of every person you speak to and note the date and time. Make notes of what they say. Most big companies have case managers that deal exclusively with special procedures like this. If not, then with the codes below, you should be able to get somewhere with the rep you talk to. The codes to ask if they are covered are: laparoscopic surgical adjustable band:Procedure code 43770; diagnosis code 278.01 Once you have found out from them if they cover it and what the requirements are, ask them to snail mail (and email if they can) you a copy of those requirements.<!-- google_ad_section_end --><!-- / message --><!-- sig -->
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So this is all new to me although I've been doing research and going to doctors visits and having all kinds of tests done and well my doctor finally gave me the referral to a surgeon. Although I confused. I called the doc and I have to do some seminar before they can give me an apt. The girl was really nice and advised me to see if my insurance covers bariatrics and to not ask to many questions, so I did just that. I was advised that it is covered if medically needed once approved they will cover 100%. I also asked where on line I could find the requirements so she told me where and so I went to look but that info is not online. So I came across something else in the benefits website under doctor search and it didn't have names of doctors but approved facilities for bariatrics and this doctor is not affiliated with any of the 4 hospitals in the Chicago land area! So am I just wasting my time with this seminar if this doctor isn't affiliated with one the the 4 hospitals? Ugh... Anyone have a suggestion for me. I will tell you that I was diagnosed with sleep apnea (just received my cpap machine a week ago) my BMI is 41 or 42 and I have been having back issues and went to therapy and MRI's and nothing is wrong mechanically. I have issues with my ankles and knee's giving out I'm like 5'. 0.5" and as of yesterday 219 (I lost 5 lbs this month, I'm so proud). I have BCBS of GA and I live in Chicago land area go figure out of state insurance! Does any of this look hopeful? Some one anyone give me some inspiration words of wisdom. I've been wanting and pushing doc to say ok lap-band since early this Year and it's now August and I just turned 30 2 weeks ago and want to enjoy my 4 year old daughter and life.
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I have heard that most bariatric docs reccomend you not having any plastics after weight loss until you are a year out from reaching goal..and even some plastic docs will nto touch you until then ..anyone else ever hear this?
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Vitamins for stopping hair loss. Yes or no?
happynewbie posted a topic in POST-Operation Weight Loss Surgery Q&A
I have a quick question. If I order some bariatric vitamins that are for helping to stop hair loss will this effect my bariatric multivitamin? Like will I get too much of certain vitamins? Also has anyone tried these and did they help or not? I am losing tons of hair after 3 and a half months out from surgery, it’s scaring me I need some advice! -
One way is to have documentation from your PCP. I have Aetna as well and am finishing up my 3 month requirement. My bariatric surgeon states you don't necessarily need to try weight watchers or jenny craig type programs, but even simple documentation from you PCP stating that you and them have discussed weight loss goals, any recommendations they've given you, your weight history throughout the years, even documentation from you gyno will help. My doc also asked if i've tried certain diets on my own like south beach/atkins and i told her i have and she put that into my list of things i've tried. i also included my visit history of the gym i have been attending for the past 4 years. hope this helps
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Welcome to the lapband journey. I went to my first orientation meeting in October and by the end of December had finished jumping through all the hoops of clearances that both the bariatric program and/or my insurance required from me. I had a documented history of the weight with my doctor and weight watcher books showing I had been doing that for 6 months faithfully. Once they got the insurance submission in, it was back in about 2 weeks. Then it took 6 weeks to get on the surgery schedule. I had my surgery on March 17 and I've never regretted it. Still need to lose about another 60 lbs but its going slowly now. Mostly due to my own stubborness at wanting to eat 'easy' foods when I want comfort - even though I know better. The key for me is to keep trying and remember I never want to go back to where I was 140 lbs ago! Best wishes.
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If you're located near Dallas. Have you tried Kim's Bariatric? They did all the paperwork for me, an on appeal, my revision was approved. I didn't have any health issues except high blood pressure. My insurance is BCBS of Texas too.
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3 week stall, still have nasty gerd, and FINALLY found restriction...
heatherdbby replied to SleeveToBypass2023's topic in POST-Operation Weight Loss Surgery Q&A
my office requires chewable. no gummies bc they have hidden carbs and sugars. no capsules bc they add additional barriers on absorption. My surgeons office gave us a full long list of their recommendations, and broke down which ones had additional supplements we had to add with it (example, if you take flintstones complete, you need to add calcium and b complex) I chose the one that was a complete that didnt need additional supplements, and the dietician said that she does not see defiencies with that one, its bariatric fusion, the one that says complete chewable. https://www.bariatricfusion.com/collections/bariatric-multivitamins -
I'm scheduled for March 8, 2011 now and would love to hear experiences with the Scottsdale Bariatric Hospital and Dr. Blackstone. I read somewhere that Dr. Blackstone offers a massage on the 2nd day post-op. Does she still do this?
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All good responses above. I had the same reaction after visiting some bariatric forums. It’s normal to worry and stress over surgery procedures. There are risks with ANY type of surgery. Talk to your surgeon about the statistics for complications. Know that your team will take good care of you. Your pain will be managed with medication. I’m five years out. No complications.
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I am almost 5 years post-sleeve surgery, and last fall, in a Covid-Cleaning frenzy, I threw out all my old, post-surgery information. As usual, as soon as one pitches something, they need it. I have just had hiatal hernia surgery and am on a full liquid diet, but on Wednesday I can move up to the post-surgery soft diet- except I don't have my food lists anymore! Can someone list what's on a soft food diet, or describe what types of foods I can or cannot have (probably easier)? I've looked this up online but didn't find any soft-food diet that seems to be specific to bariatric weight loss patients, and I'm not sure our soft food diet would be the same as what is prescribed for the general public. TIA!
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Can someone remind me?
Starwarsandcupcakes replied to leebick's topic in Post-op Diets and Questions
Technically speaking they would be the same except a bariatric soft would focus more on proteins than just general calories. This would include easy to chew foods that are also easily digestible. This list will give you an idea of what to include and stay away from. Keep in mind though that actual liquids are ok with soft foods, especially after hernia repair. -
I think most of us had to have a sleep study to check for sleep apnea - that's a pretty common screening for this surgery. I can't remember if that was a requirement of my insurance or my bariatric clinic. I had it closer to the beginning of my journey, though.
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The old policy didn’t include bariatrics at all.
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Can anyone help me figure out what this means? They said that bariatrics are included with our new insurance but this makes no sense to me. I’ve called insurance and all they did was read it to me and can’t explain it any further. I have calls into places to meet with surgeons but don’t want to get my hopes up if this isn’t going to happen. Thanks in advance.
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Weight loss expectations VSG to RNY??
mi75 posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Almost 8 yrs VSG and had severe GERD beforehand. It significantly decreased post op but I've remained on PPI medication the entire time. I was down to 1-2 total doses per week, however I had some regain over the last year and am up to THREE TIMES daily!! It's everything to do with how I carry my weight- all in my middle. While I was quite satisfied with the GERD being almost totally resolved initially, I'm fearful that even IF I lose the current regain it won't go away to the extend that it was in the past. I have been told by my bariatric team that a revision is likely the ONLY way to get the GERD to go away with 100% certainty. That sounds pretty good to me but I am quite fearful of surgery in general because I'm a nurse practitioner and we make terrible patients... I would love to know what the loss pattern was like for those who had the revision and can I plan to see awesome results? I mean, BESIDES the GERD clearing up? I am currently about 40 lbs about my ULTIMATE goal- I never reached that goal with my VSG, stopping about 12 lbs away from it...