65 and over

[toler48 120]

Lady1putt

Linda, you mentioned getting free samples. How do we go about doing that? Do you have address's for different ones?

Cathy

[*Kate* 10]

toler48, do let us know. And good luck with your journey. Going to Colorado was annoying, especially since it just didn't seem right to have to travel to another state to have a necessary procedure done. But in the end it was so worth it! Both of my knees were bad and I hoped that losing weight would help. It didn't, so I had my first one done in late January and the second one will be done this Friday. Three big surgeries in less than a year isn't easy, but so far so good. I do think losing the weight has made my recovery from the knee surgery easier.

[Bubbletoes 124]

My surgery date is just 3 weeks away, yet I'm still waiting for official approval from my insurance company. I have been having an ongoing problem with this since January and now that it's getting down to the wire, I'm getting nervous! My story probably isn't unique, but I find it pretty ridiculous. I work full time at a local hospital and have my insurance through them. My hospital began a Bariatric program last year so I jumped at the chance to go to a seminar and begin the process to eventually have a VSG. I called my insurance company and was assured that they (Aetna) would pay for this surgery after a $250 deductible. Awesome! I began the program and after a few weeks, my navigator called me to tell me that my insurance has hit a snag. For employees of my hospital Aetna won't pay for surgery not done at a hospital without a Center of Excellence designation, including my own. The program at my hospital is too new to qualify for that yet. I called and asked about other hospitals in the area. Sure, I can have it done, but it will be out of network and the bulk of the cost will be all mine. Amazingly, my hospital has had all this fanfare about the Bariatric program beginning, ALL employees have had to go through "obesity sensitivity" training, and there are posters about it all over the hospital. My surgeon has appealed to administration and administration has appealed to Aetna to drop that requirement in my case and possibly some others. After months of talks, they are still at a standstill. Can you say frustrating??

I have a BMI of 40, I've had diabetes for 41 years (insulin dependent), hypertension, have CAD with a stent in one of my coronary arteries, and recently found to have severe sleep apnea found during my sleep study I had as part of preop testing. I'm currently using a CPap. My health has been very good until the last few years, thanks to the ravages of diabetes, and even though I've been on a healthy eating regimen, weight loss has been slow to nil. I need this surgery! My husband has fantastic insurance, but adding me to his would cost over $900 a month. Not an option!

If this doesn't go through I will go to Plan B: wait until December when I turn 65 and go through Medicare. It's not what I want, but at least it will be there (I hope!) if I need it.

[reallyrosy 161]

Its mindboggling and i think they do it just to get us riled up. Hartfird told me i am NOT COVERED BY ANYONEZ AND it doesn't matter what the insurance pole tell me. I MUST get the more invasive procedure. Yale told me oh my your ins7rance is golden. You can have whatever you want and then offered only the bypass. No thanks i will pay for VSG. Bingo, they are funding the whole thing. Duh

[patsy1947 42]

insurance is crazy, I waited a whole year from start to finish with insurnce and all kinds of appointments.. so i understand how depressing it is to want something so bad and have to wait so long for it.. but once it comes down to the wire and the operatiion is here you will feel reborn. and be so happy you finally had it done. You are going to have many ups and downs but hang in there its all worth it and everyone on this sight is here to help you and answer your questions.. we have been there.. good luck to all .

[toler48 120]

I got my new patient forms today. Seminar is tomorrow night. Baby steps but still steps.

Don't know for sure about insurance yet, hope to find out more tomorrow night.

[patsy1947 42]

the seminar s are good. you will learn a lot at it..

[toler48 120]

Well fudge! Seminar tonight has been canceled. Seems there are surgery conflicts or something.

On the bright side, when they called to say it had been canceled, they said that the Doc is going to wave the copay for my consultation on May 1. That is very nice of them.

So I wait a little longer, sigh.

[Cococat 119]

Sorry that your seminar was cancelled. If they don't jerk us around one way, they do it another. Hang on. It is worth it.

[Lady1putt 24]

Oh no! Update ......today is 2 week anniversary of post op!

I have hit " onederland". Down 21 pounds but who is counting! LOL!

Feeling proud! It has been years!!

[toler48 120]

Congrats!! You should be proud!

[Bubbletoes 124]

Awesome, Patsy! Keep up the good work!

[Bubbletoes 124]

Just a quick update on my dilemma... it looks like Aetna will relent on the center of excellence requirement but I still don't have any solid reassurance yet. My surgeon says forge ahead! My EGD is scheduled for April 29, the same day I start my five day preop liquid diet. I'm still on the schedule for a May 4th sleeve so I am finishing up my paperwork for medical leave this week. I'm keeping my fingers crossed! ????????????

[Cococat 119]

It's funny that they insist on making you go through a psychological screening ... and then DRIVE YOU CRAZY with the insurance thing.

[patsy1947 42]

bubbletoes, I am keeping my fingers crossed for you. Im sure your doctor expects things to go ok or he wouldn't have gave you the green light . keep me posted