Shaye 6 Posted January 10, 2013 Hi all, ive been on here a few days reading posts and posting some myself! I just switched to uhc and.sent all my paper work back to surgeons office. Im waiting for a seminar...like i said, very begining stages! I have not always been heavy, the weight came on after my third child. I was a size 9 after my second child but slipped into depression after my third and just gained! My highest weight was 250lbs! I have tried every diet out there, and was successful untill i started living life again lol. I would lose 50lbs and gain it back then diet again and gain again. Now im 35 yrs old and it is getting harder to lose! I lose about 25lbs and cant seem to lose any more and dont even drop a pant size...thats frustrating!! So im turning to the sleeve. Im 5'6, 245lbs bmi of 40. Cant wait to get this going!! Share this post Link to post Share on other sites
girlchild 5 Posted January 10, 2013 I, too, was/am UHC. Have you spoken with them about your intent to have WLS? I ask because SOME of their plans (such as mine) require you to consult with their Behavioral health arm prior to approval. Although my doc spoke with UHC at the very start, it wasn't until I had scheduled the psych eval that this flag was thrown - halfway through the process! The good news is, it caused no delays and I got 1st letter approval, but it caused a month of unnecessary stress/great on my part. So, if you haven't, do call UHC and confirm what they require by way of in-house consultation. Best of luck on your journey! Share this post Link to post Share on other sites
Shaye 6 Posted January 10, 2013 Thanks! I did call before i even contacted surgeon, just to make sure it was possibler at all! They just said they cover 80% with a bmi of 35 with comorbidities or bmi of 40, i asked if there was any "extras" like the six mo diet some people have to do or anything like that. She also said no on that. I think it all depends on who you talk to you, i think things will change once my request is sent after all this evaluation stuff. Thats what worries me. It sounds too good to be true, its all too easy from talking to surgeons office and insurance. But then i read on here some people getting denied and the stress they are going through!! Ugh Share this post Link to post Share on other sites
Shaye 6 Posted January 10, 2013 I' date=' too, was/am UHC. Have you spoken with them about your intent to have WLS? I ask because SOME of their plans (such as mine) require you to consult with their Behavioral health arm prior to approval. Although my doc spoke with UHC at the very start, it wasn't until I had scheduled the psych eval that this flag was thrown - halfway through the process! The good news is, it caused no delays and I got 1st letter approval, but it caused a month of unnecessary stress/great on my part. So, if you haven't, do call UHC and confirm what they require by way of in-house consultation. Best of luck on your journey![/quote'] Oh, and we have high option. For got to mention that. They cover 80% of surgery after our $350 deductable. Share this post Link to post Share on other sites
betsyann07 21 Posted January 10, 2013 I had to meet with someone in behavioral health and honestly, it was one of the best things for me in this process. I had a lot if emotional eating issues and just eating out of boredom. I think had I not gone thru that process I may not have established the strategies I have not to overcome those issues. I feel much more confident that I can lose weight and keep it off rather than gaining it all back a way down the road. But that's just me . All this being said, part if me hopes that my stomach just can't tolerate the bad stuff after this so the temptation is lessened! Share this post Link to post Share on other sites
SweetnCurvy 112 Posted January 10, 2013 Hi all' date=' ive been on here a few days reading posts and posting some myself! I just switched to uhc and.sent all my paper work back to surgeons office. Im waiting for a seminar...like i said, very begining stages! I have not always been heavy, the weight came on after my third child. I was a size 9 after my second child but slipped into depression after my third and just gained! My highest weight was 250lbs! I have tried every diet out there, and was successful untill i started living life again lol. I would lose 50lbs and gain it back then diet again and gain again. Now im 35 yrs old and it is getting harder to lose! I lose about 25lbs and cant seem to lose any more and dont even drop a pant size...thats frustrating!! So im turning to the sleeve. Im 5'6, 245lbs bmi of 40. Cant wait to get this going!![/quote'] I have UHC too. Good luck and welcome to the site:) Share this post Link to post Share on other sites
girlchild 5 Posted January 10, 2013 Shaye, even with the "curveball" of having to consult with Behavioral Health, the process went very smoothly with UHC for me. They covered 80/20 on mine, too, and required much less than most I've seen (no weight history, supervised diet... they didn't even require NUT visits, but I opted for them regardless). I have been so pleased with them. Share this post Link to post Share on other sites
Shaye 6 Posted January 11, 2013 Shaye' date=' even with the "curveball" of having to consult with Behavioral Health, the process went very smoothly with UHC for me. They covered 80/20 on mine, too, and required much less than most I've seen (no weight history, supervised diet... they didn't even require NUT visits, but I opted for them regardless). I have been so pleased with them.[/quote'] Oh wow! Ya i would want to see nut too. I think the surgeons office requires it though. But id prob wanna see behaivor health too just cuz i find i make bad choices when really hungry and i eat when bored or happy or mad. Lol. When do they bill the 20% and if u dont mind me asking, how much are payments on that? Might be different for each person..idk Share this post Link to post Share on other sites
girlchild 5 Posted January 12, 2013 Oh wow! Ya i would want to see nut too. I think the surgeons office requires it though. But id prob wanna see behaivor health too just cuz i find i make bad choices when really hungry and i eat when bored or happy or mad. Lol. When do they bill the 20% and if u dont mind me asking' date=' how much are payments on that? Might be different for each person..idk[/quote'] I think it depends on the hospital as to when they bill you. Some do right before surgery and others will wait until insurance has paid their part before billing the balance you owe. Same goes for payment terms. Some will offer installments, others want it all at once. If you call the acct dept of your hospital/facility, I'm sure they can tell you what to expect. Share this post Link to post Share on other sites
Shaye 6 Posted January 12, 2013 I think it depends on the hospital as to when they bill you. Some do right before surgery and others will wait until insurance has paid their part before billing the balance you owe. Same goes for payment terms. Some will offer installments' date=' others want it all at once. If you call the acct dept of your hospital/facility, I'm sure they can tell you what to expect.[/quote'] Ok thank you for the info! This is my first time having insurance pay for anything major! just usually reg doc.appts lol. I will def call and find out!! Share this post Link to post Share on other sites
Shaye 6 Posted January 16, 2013 Yay...got my semimar date.finally..lol Share this post Link to post Share on other sites
Shaye 6 Posted January 18, 2013 January 30th....going to seminar! I know, im a newbie!! Lol but man am i excited to just go to this and start the process! Share this post Link to post Share on other sites
girlchild 5 Posted January 18, 2013 You have every right to be excited You are about to embark on a remarkable journey! Share this post Link to post Share on other sites
trujiyi 9 Posted January 18, 2013 This is definitely a great decision and you are doing it at a perfect age. I am 43 and will tell you it gets tougher to lose the weight after 40. Good luck and stay motivated. The process can be long and cumbersome but worth it. After 6 long months In this process i got approved yesterday and I scheduled my surgery for February 14 Happy Valentines day to me... What better way for me to show myself love:) Share this post Link to post Share on other sites
Shaye 6 Posted January 18, 2013 This is definitely a great decision and you are doing it at a perfect age. I am 43 and will tell you it gets tougher to lose the weight after 40. Good luck and stay motivated. The process can be long and cumbersome but worth it. After 6 long months In this process i got approved yesterday and I scheduled my surgery for February 14 Happy Valentines day to me... What better way for me to show myself love:) That is awesome!! you will never forget your surge-versary! Im figuring it taking about 6mo, but the lady at the surgeons office said from day if seminar to day of surgery is only about 2-3mo...i hope!! Congrats on your date, i bet youre soooo excited, everytime i hear someone on here say they were approved, i get excited for them cuz i know how im gonna feel when/if i get approved!! Share this post Link to post Share on other sites