New here!! =)

[AllForMy4 58]

Hi everyone! My name is Liz and I am new to this site hoping to have the sleeve done. I have started the process beginning with a visit to my doctor and starting yet ANOTHER diet and exercise plan with her while getting the ball rolling(for documentation). I have an appt for a sleep study the week after next. I am currently 5'3" and weigh 265,my bmi is 46!! I have high cholesterol,very high triglycerides,and the early on set on diabetes and I am pretty sure I have sleep apnea...I am only 25 yrs old,I have tried dieting unsuccesfully and end up yo yo-ing since about age 13. Been overweight since I was 10..it is serioulsy taking a toll on my body and my life in general. Thank God I have a husband who truly loves me for me and is very supportive of my decision to have WLS. I have 4 beautiful children who will benefit greatly from having a healthier mommy! Soooooo,on November 10th I am attending a seminar that my surgeon,Dr. Patrick Coates,requires before surgery. There I will gain more insight on the sleeve(even though I think I may have OVER researched it already and can pass a quiz on it lol),meet the surgeon,and schedule my initial consult. I am really anxious to get everything taken care of and approved and start on this life changing journey!!!! So while impatiently waiting for the seminar date to come,I will be completing my psych eval and meeting up with a dietician. Anyone else had the surgery with Health Net insurance? I really want to get it approved on the first submit of my paperwork to Health Net so I am trying to have all the requirements met before hand. Anyhow,so sorry for the long post!! I am looking for support here and any info I can get on helping getting approved or requirements to get approved on the first time.. my husband is supportive of my decision but noone else in my fam is...at all. My older sister had the RNY done back in 08 and while she lost well over 100 pounds,she has had nothing but problems....So instead of my fam researching the sleeve or even listening to me try to educate them on the differences between it and the RNY,they just get mad at me saying it is not the right choice...anyhow,I will quit while I'm ahead bc that's another story!! LOL I hope to make lots of friends here!!!

[Oopsseedaisy 90]

Welcome to VST! You will find lots of good people here and tons of great advice. Look around read and ask questions. We are here for support. ~Hugs

[YOLANDA240 13]

Welcome and good luck with your journey. Sorry can not answer insurance question, I went through United Healtcare.

Take Care

Hi everyone! My name is Liz and I am new to this site hoping to have the sleeve done. I have started the process beginning with a visit to my doctor and starting yet ANOTHER diet and exercise plan with her while getting the ball rolling(for documentation). I have an appt for a sleep study the week after next. I am currently 5'3" and weigh 265,my bmi is 46!! I have high cholesterol,very high triglycerides,and the early on set on diabetes and I am pretty sure I have sleep apnea...I am only 25 yrs old,I have tried dieting unsuccesfully and end up yo yo-ing since about age 13. Been overweight since I was 10..it is serioulsy taking a toll on my body and my life in general. Thank God I have a husband who truly loves me for me and is very supportive of my decision to have WLS. I have 4 beautiful children who will benefit greatly from having a healthier mommy! Soooooo,on November 10th I am attending a seminar that my surgeon,Dr. Patrick Coates,requires before surgery. There I will gain more insight on the sleeve(even though I think I may have OVER researched it already and can pass a quiz on it lol),meet the surgeon,and schedule my initial consult. I am really anxious to get everything taken care of and approved and start on this life changing journey!!!! So while impatiently waiting for the seminar date to come,I will be completing my psych eval and meeting up with a dietician. Anyone else had the surgery with Health Net insurance? I really want to get it approved on the first submit of my paperwork to Health Net so I am trying to have all the requirements met before hand. Anyhow,so sorry for the long post!! I am looking for support here and any info I can get on helping getting approved or requirements to get approved on the first time.. my husband is supportive of my decision but noone else in my fam is...at all. My older sister had the RNY done back in 08 and while she lost well over 100 pounds,she has had nothing but problems....So instead of my fam researching the sleeve or even listening to me try to educate them on the differences between it and the RNY,they just get mad at me saying it is not the right choice...anyhow,I will quit while I'm ahead bc that's another story!! LOL I hope to make lots of friends here!!!

[emily_0192010 168]

Hey!! Congrats on taking the first step, you will be on the "loser's bench" before you know it! Our stats are very similar. I am 5'2 at started at 262 with a BMI of 47. It is totally worth it! As for your family, you might want to try making or finding a brochure of the facts about the sleeve versus RNY. Maybe even get your sister on board. They are very, very, very different and the sleeve is one of the least drastic things you could chose to have done. Our sleeves work exactly the same way as our old stomach's, just smaller!

Anyways, you have come to the right place. This board is an amazing place for support and information. i don't know what I would've done without it!

[AllForMy4 58]

Welcome to VST! You will find lots of good people here and tons of great advice. Look around read and ask questions. We are here for support. ~Hugs

Thank you so much! I love this site already and love browsing the forums!

[AllForMy4 58]

Hey!! Congrats on taking the first step, you will be on the "loser's bench" before you know it! Our stats are very similar. I am 5'2 at started at 262 with a BMI of 47. It is totally worth it! As for your family, you might want to try making or finding a brochure of the facts about the sleeve versus RNY. Maybe even get your sister on board. They are very, very, very different and the sleeve is one of the least drastic things you could chose to have done. Our sleeves work exactly the same way as our old stomach's, just smaller!

Anyways, you have come to the right place. This board is an amazing place for support and information. i don't know what I would've done without it!

Thank you! Congrats on your weight loss so far!! I feel that the sleeve is right for me for the exact reason that it works the same as a regular stomach only smaller. My sis had a hernia after the RNY,had a horrible time with dumping,and 2 months later had to have her gallbladder removed after being rushed to the ER in severe pain!!! Also her hair started falling out bc she couldn't absorb the Vitamins right!!! Although she lost the weight and she is below goal now,it was very scary for everyone but I am trying to express to them that the VSG is not like the RNY at all really.

[AllForMy4 58]

Welcome and good luck with your journey. Sorry can not answer insurance question, I went through United Healtcare.

Take Care

Thank you!! I actually got my insurance questions answered today by a couple ppl at my surgeon's office and also my insurance customer care..My surgeon's office said that it is VERY hard to get an approval for the VSG through Health Net and advised me to switch to my only other option at this time which is Anthem Blue Cross,so I am changing it on the 26th of this month!! Love your ticker BTW!!!

[hadouni 301]

Hi Liz-

I have Anthem Blue Cross PPO and Dr. Coates (in Modesto? Can there be many Coates who do WLS??) is not an option for me with my employer's Blue Cross plan. This journey has been super confusing for me because I'd found a surgeon in Fresno only to have a customer service rep with Anthem Blue Cross tell me that surgeon wasn't an option. They gave me a list of options in the Central CA area and Modesto Memorial was on the list so I went to Coates' seminar. After the seminar the office called me to see if I wanted to come in for an initial appointment and I went in only to find that my insurance wouldn't cover surgery with them! In the end (and after some very frustrating phone calls) I'm back with the original surgeon in Fresno and supposedly this group in Fresno is the only Central CA option for my employer's Anthem Blue Cross PPO plan.

I also just read something someone posted about their new insurance making them wait they'd been covered with them for a year until that insurance would cover WLS at all.

The insurance quagmire is soooo confusing... just be careful switching and if you can get some guarantees in writing...

Good luck!!

[AllForMy4 58]

Hi Liz-

I have Anthem Blue Cross PPO and Dr. Coates (in Modesto? Can there be many Coates who do WLS??) is not an option for me with my employer's Blue Cross plan. This journey has been super confusing for me because I'd found a surgeon in Fresno only to have a customer service rep with Anthem Blue Cross tell me that surgeon wasn't an option. They gave me a list of options in the Central CA area and Modesto Memorial was on the list so I went to Coates' seminar. After the seminar the office called me to see if I wanted to come in for an initial appointment and I went in only to find that my insurance wouldn't cover surgery with them! In the end (and after some very frustrating phone calls) I'm back with the original surgeon in Fresno and supposedly this group in Fresno is the only Central CA option for my employer's Anthem Blue Cross PPO plan.

I also just read something someone posted about their new insurance making them wait they'd been covered with them for a year until that insurance would cover WLS at all.

The insurance quagmire is soooo confusing... just be careful switching and if you can get some guarantees in writing...

Good luck!!

Thank you for that info!! My surgeon is Dr.Coates in Modesto!! I looked up Anthem Blue Cross's Medical Policy online and it says they cover the sleeve if you are an eligible candidate. Here's the link:

http://www.anthem.com/ca/medicalpolicies/policies/mp_pw_a053317.htm

It is listed in the first paragragh along with all the other types of WLS. It is listed as "Sleeve Gastrectomy" This may or may not be the info you need but DONT GIVE UP!! I would call your insurance directly and ask how you can view their medical policy online. They should be able to provide you with a link to your actual plan with them. And it is always better to see it in writing yourself rather than to be possibly told numerous things by different agents... Thank you so much for the advice about maybe having to be with them for a certain amount of time before the surgery is covered. That's a great question to ask my insurance lady when I go in tomorrow to possibly switch my plan!!! As far as Dr.Coates office having a contract with Anthem Blue Cross,I talked to about 4 ppl from their office yesterday that confirmed that Anthem Blue Cross does cover the sleeve with them,bc I kept calling back to make sure!! LOL. I would call Dr.Coates office and talk to them if you may still want to have the surgery done there. They are very helpful and have an awesome pre-authorization worker!! I'm sure if you give her your exact insurance info as far as what plan you are under with Anthem Blue Cross,she should be able to give you some valuable advice. Hope this helps-It would be awesome to go through this journey with someone local!!!

[hadouni 301]

Hi Liz,

The information I've received is Blue Cross is covering the sleeve (yay!).

I was directed over the phone to Coates (Modesto Memorial) *by* Anthem Blue Cross PPO and when I was in Coates' office and his staff tried to run my insurance information it came back that Coates wasn't an option for me/my insurance. Before I went to Coates I had called Anthem Blue Cross, identified myself with my member & group number and was even transferred to an "expert" in my group plan and gave them the tax ID number of the hospital I wanted to go to in Fresno AND the surgeon's name and was told I had to go to a Center of Excellence and the options for me were: Clovis Community Medical Center, St. Agnes in Fresno and Modesto Memorial Hospital (Coates' group).

There is conflicting information on the Blue Cross website as well. When I log into Blue Cross through my employer homepage the information I'm directed to is for Anthem Blue Cross/Blue Shield and the info listed on-line is for the three Centers of Excellence above. However, when they tried to run my insurance info at Coates' office, it was denied and I finally got to someone who e-mailed me confirmation that the only place I can go to in Central CA is Fresno Heart Hospital (actually called Fresno Heart and Surgical Hospital).

Insurance is CRAZY LAND... I'm convinced! I believe Blue Cross does cover Coates through some of it's groups/group plans... just not mine... I'm also very happy with the surgeon in Fresno and Fresno or Modesto are about the same distance for me.

[AllForMy4 58]

Hi Liz,

The information I've received is Blue Cross is covering the sleeve (yay!).

I was directed over the phone to Coates (Modesto Memorial) *by* Anthem Blue Cross PPO and when I was in Coates' office and his staff tried to run my insurance information it came back that Coates wasn't an option for me/my insurance. Before I went to Coates I had called Anthem Blue Cross, identified myself with my member & group number and was even transferred to an "expert" in my group plan and gave them the tax ID number of the hospital I wanted to go to in Fresno AND the surgeon's name and was told I had to go to a Center of Excellence and the options for me were: Clovis Community Medical Center, St. Agnes in Fresno and Modesto Memorial Hospital (Coates' group).

There is conflicting information on the Blue Cross website as well. When I log into Blue Cross through my employer homepage the information I'm directed to is for Anthem Blue Cross/Blue Shield and the info listed on-line is for the three Centers of Excellence above. However, when they tried to run my insurance info at Coates' office, it was denied and I finally got to someone who e-mailed me confirmation that the only place I can go to in Central CA is Fresno Heart Hospital (actually called Fresno Heart and Surgical Hospital).

Insurance is CRAZY LAND... I'm convinced! I believe Blue Cross does cover Coates through some of it's groups/group plans... just not mine... I'm also very happy with the surgeon in Fresno and Fresno or Modesto are about the same distance for me.

OHHHH I am a bit ditzy! lol,ok so you're having your surgery in Fresno?? That's awesome! Good luck to you and keep us posted!