My Introduction..

[StephO 0]

Hello everyone.. My name is Stephanie. I registered for these forums for support, and to have some questions answered. I've been researching bariatric surgery for quite awhile now (probably at least 2 years), and have finally made the decision that I do want to go forward with surgery. I feel like a weight has been lifted in a way, and I wish I would have come to this decision a long time ago. I've tried many many things over the years to lose weight (like everyone here, I'm sure), and I feel like I've gotten to the point that I need some help. I want to make the lifestyle change necessary to live my life in a way I dream of. I don't want my weight to hold me back anymore.

I am 24 years old, and have been overweight pretty much my entire life. I am 5'9", and weigh 355lbs, and my BMI is 50+. I think that's the first time I've told anyone other than my husband or mom what I weigh.. I guess it's a step of progress, right? I have Kaiser Permanente for insurance, and after looking over the benefits/coverage, I saw that the surgery is covered. This is a huge relief, as I was thinking we'd have to make some serious sacrifices to come up with the $10k+ to do it out of pocket.

My questions are about going through the process and what is needed, what I have to do, etc. I've read about long waits, and tons of loops to go through. I will only be covered under this insurance until October of 2012. Is this enough time for me to have the surgery done? I understand you have to be referred by your primary care doctor, and I have sent a message to her tonight informing her of my decision and asking for the necessary information. For those who have gone through it- after the referral, then what? Do you immediately start classes? Is there an approval process? Appointments? I'm trying to get a feel of how long this will take, because I will need to make arrangements to take care of this.

I really appreciate any information you all have to give me. Thank you.

[StephO 0]

Yikes, nothing yet...anyone out there?

[AMayo1 2]

Every insurance and every doctor is a little bit different. My insurance requires a 5% weight loss and it must be completed in 6 months, my doctor requires a 10% weight loss. Most seem to require a psyche eval to make sure that you are ready for the surgery. Depending on your medical history you will have to undergo different medical tests. At the minimum a pulmonary test, EKG, blood work, pulmonary test, upper GI, gall bladder scan, ameeting with a Physical Therapist or exercise physiologist. Other possible tests are stress test, sleep study just to name a few. It will all depend on your medical history. Do not set them up yet, wait for the surgeon's team to do that after you had your initial consultation.

You made the right first step by asking your primary for a letter of medical necessity.

Second step you need to make is to call your insurance company and ask for them to send to you in writing what requirements they have for having the surgery done. Insurance companies vary from plan to plan even state to state. Ask them when you are on the phone with them if they require you to go to a center of excellence and if so which ones do they work with in your area?

Third Step Call a bariatric surgeon's office, is there one your primary care doctor recommends? If not is there one your insurance company recommends? Look under the doctor registry on here. Once you have picked an office call them so that you can register to go to an orientation. At the orientation they will give you a packet, and they will go over what their practice procedures are for getting approved for the lap band. You can even go to several different groups orientations before you decide which doctor you want to go with.

At this point, the group I went with required a 4 day cool down period before you could call and schedule your initial consultation. From there your group should help you through the process for getting the surgery.

[StephO 0]

Thanks for your response!! I've gotten in touch with my insurance company, and my Dr, so I'm on the way. I appreciate the information!

Every insurance and every doctor is a little bit different. My insurance requires a 5% weight loss and it must be completed in 6 months, my doctor requires a 10% weight loss. Most seem to require a psyche eval to make sure that you are ready for the surgery. Depending on your medical history you will have to undergo different medical tests. At the minimum a pulmonary test, EKG, blood work, pulmonary test, upper GI, gall bladder scan, ameeting with a Physical Therapist or exercise physiologist. Other possible tests are stress test, sleep study just to name a few. It will all depend on your medical history. Do not set them up yet, wait for the surgeon's team to do that after you had your initial consultation.

You made the right first step by asking your primary for a letter of medical necessity.

Second step you need to make is to call your insurance company and ask for them to send to you in writing what requirements they have for having the surgery done. Insurance companies vary from plan to plan even state to state. Ask them when you are on the phone with them if they require you to go to a center of excellence and if so which ones do they work with in your area?

Third Step Call a bariatric surgeon's office, is there one your primary care doctor recommends? If not is there one your insurance company recommends? Look under the doctor registry on here. Once you have picked an office call them so that you can register to go to an orientation. At the orientation they will give you a packet, and they will go over what their practice procedures are for getting approved for the lap band. You can even go to several different groups orientations before you decide which doctor you want to go with.

At this point, the group I went with required a 4 day cool down period before you could call and schedule your initial consultation. From there your group should help you through the process for getting the surgery.

[AMayo1 2]

you're welcome. Hope your journey goes smoothly

[Sabrina140 0]

Hi StephO I am not sure where you are located, but I know that Kaiser does allow members to continue coverage as private pay if your coverage ends too soon just something you may want to look into 'just in case' good luck!