Any Successful Approvals with GEHA or Healthlink?

[MzGee 65]

I currently have GEHA but when I go to the doctor they refer to it as Healthlink. I am in the 6 month physician documented diet which is mandated by the insurance company and I am getting disappointed with the process. Has anyone ever been approved with GEHA/ Healthlink? Also did you lose any weight during the 6 month diet requirement? Thanks in advance

[chooter 7]

I have GEHA. I went to a gastric sleeve seminar in July 2013. Since then I've been jumping through the hoops. First my hospital (Mercy) said I wasn't morbidly obese, so I couldn't have surgery unless I had a co-morbidity. So I had a sleep study done and I had sleep apnea so that qualified as a co-morbidity. I started the 6 months of visits with my PCP, I've had the psych evaluation, met with dietician, went to an all day seminar. This week I meet with exercise and activity. I've had to keep a food and exercise log (started both of those last August). I've also met with surgeon and the RN in charge of the bariatric program. To my knowledge, I dont think they have submitted anything to GEHA yet.

I called GEHA last August to see what was required and they mailed me a sheet of requiements.

My recommendation is start tracking everything now, exercise, food journal, monthly visits with PCP. If your BMI is not 40 or greater, you'll need a co-morbidity (sleep apnea, diabetes). I'm hoping to have surgery in May or June.

[chooter 7]

Forgot to say I have not lost any weight in the 6 months worth of doctor visits. Haven't gained any either.

[MzGee 65]

Thanks for the feedback right now I don't have a PCP but I have going to a nutritionist who is covered by my insurance and keeping the logs for food and exercise, this last visit I've lost ,9lbs in one month . And initially at the wls seminar it seemed as if the insurance would be the easiest step listening to the wls advocate but now I'm not so sure.

[MzGee 65]

@@chooter I will be getting that checklist this week from GEHA , I've finished my 6month diet and I'm ready!!!

[tom_thumb 0]

Have you all learned anything new with GEHA? I have been on the 6 month visits, and next week is my PET class and Psych review. I have GEHA, and I am worried that they will deny for some reason.

[chooter 7]

I was approved by GEHA, surgery scheduled for 6-16.

[tom_thumb 0]

Congrats! That is very soon.

Did you have any obstacles? Anything off the wall I should be looking out for?

I have sleep apnea. I am on the threshold of 41-40%, so I don't want to lose too much, ya know?

[chooter 7]

I think you'll be fine since you have sleep apnea. I didn't purchase the machine since my main goal was to have the sleeve surgery.

[chooter 7]

I think you'll be fine since you have sleep apnea. I didn't purchase the machine since my main goal was to have the sleeve surgery.

[tom_thumb 0]

yeah, You can purchase it after the surgery "if" needed. But the weight loss may fix your apnea. I sure hope I can breath easier at night.

[myfutureme 13]

I also have GEHA. I talked with them a million times before starting this process. Now, AFTER 6 months of diet and exercise they tell me that I was supposed to be writing down each activity and the duration this whole time. And my PCP didn't take detailed enough notes. Great. So now I sent more info and am awaiting another letter

[MzGee 65]

I got approved in 2weeks ! I got the good news today.

[chooter 7]

Surgery on 6/16, with 1 night in the hospital, all went well (though no sipping liquids while laying down, it will come back up). Stomach was a little sore (6 holes). Went in to hospital weighing 216.5, weighed yesterday and down to 212.

You seriously don't feel like eating, your not hungry at all, no cravings, no nothing. I think I'll have to just set up a schedule to remind myself to eat something. Right now I'm doing Protein shakes, sugar free jello/pudding, greek yogurt, sugar free ice pops and malt-o-meal. You can only eat about 1/2 cup of food at a time, it takes me like an hour to get down the small container of greek yogurt.

[chooter 7]

Forgot to mention that at my last meeting with surgeon, I had to pay $4,900 before they would schedule surgery. This is what was not covered by GEHA.