Starting the Process

Pretty In Pink · August 22, 2011

Hello, I'm new to the site. I have been on this site for about 2 weeks now and finally decided to join. I am 36 years old I'm 5'3 and weigh 203. I have struggled with my wieght for the past 10 years. I started the WLS process about a month ago. I have attended an informational meeting about a year ago, but finally decied I just need to do this. I am scheduled for a sleep study on Wednesday. I don't have any type of health problems and they referred me for a sleep study to help me get approved with a sleep apnea diagnosis. I have BCBS I don't know if they are going to require a psych eval or some type of diet, but I'm anxious. Does anyone know what's the next step after the sleep study diagnosis?

owl · August 22, 2011

I didn't have to have a sleep study. I have BCBS of Florida. All they required was 6 consecutive months of seeing a physician for weight loss. I started 3 times over because I missed a month here and there. I got so fed up with them I went to my mom and was given an earlier inheritence, for which I am very greatful. I would suggest you speak with who ever does the billing for the physician/surgeon you are seeing. They will have the best information. Hang in there and good luck with your insurance. owl

Nancy Rivers · August 22, 2011

You're best bet will be to contact your insurance company to find out if they cover the procedure or not. If they do, then ask what are their requirements for covering the surgery. Every POLICY is different - just because BCBS covers for one person does not mean they will cover for a different person. I have BCBS and any type of wls was specifically EXCLUDED with my policy. I had to pay out of pocket for the whole thing.

Once you know if the insurance will cover and what their requirements will be, then your surgeon's office will follow those guidelines at the very least. He or she may require more depending on your medical history.

Fusilli66 · August 22, 2011

Have you met with a surgeon yet? I found that my surgeons office was extremely knowledgeable about the process and very helpful. When I first called my surgeons office I asked a lot of questions, including what was required for my insurance (GHI). When I met with the surgeon he gave me a slip of paper for each doctor I needed to see and what I needed to get done. The process was a little tedious and I had a lot of appointments, but it is done now and hopefully I am being submitted to the insurance company this week.

Good luck!

Pretty In Pink · August 22, 2011

I'm going through the bariatric center at the local hospital. I did call my insurance and it is covered, but I never asked what are the requirements for the procedure. The bariatric center has asked me for all my medical history. I recently had a endoscopy just to get it out of the way. I hope they don't require some type of diet before they approve me. I have been on all the diets our there and I just can not stay on a diet to save my life! My mother and sister are not supportive of the surgery. They are thin and have never struggled with their weight like I have. My sister is always on my case about not having will power. I made a decision not to include them. I have my husband's full support and that's all that matters at this point. I want this so bad. I am just so ready. I want to feel good about myself.

I will call my insurance company and ask what the requirements are.

thank you all for your support through this journey!

Have you met with a surgeon yet? I found that my surgeons office was extremely knowledgeable about the process and very helpful. When I first called my surgeons office I asked a lot of questions, including what was required for my insurance (GHI). When I met with the surgeon he gave me a slip of paper for each doctor I needed to see and what I needed to get done. The process was a little tedious and I had a lot of appointments, but it is done now and hopefully I am being submitted to the insurance company this week.

Good luck!

August 22, 2011

I would check to see if they take impact on your joints as a comorbity. Cigna does. Then I would have my knees checked by an ortho doc and tell them my knees hurt! A knee specialist will evaluate your knees for the cost of an office visit. The first thing ANY ORTHO DOC says is lose weight. Weight is their excuse for everything no matter how overweight you are!! They will surely write something for you!!!