Cry

[mal0712 101]

I want to cry at how overwhelming all of this is! I want this surgery so bad that waiting to do a diet makes it seem hopeless... I get the liquid diet 3 weeks before surgery,but the 6 month thing seems kinda shady to me. If a crack head needs rehab do you say ok now dear u must go with no crack for 6 months and then we will help u. ????. For a lot of us this is food addiction related and 6 months may be too late. I'm done venting and crying now lol. Much love and respect to all of u that made it through the weight loss journey without goin crazy!!!!

[esskay77 785]

I totally agree with you and have been there myself! Once I made the decision to have the surgery, I wanted it right then! I think part of it is insurance mandates and each insurance plan has different requirements. Some make you weight a couple of years, some there is no waiting period and of course all the stuff in between.

Now that I have been through it, and am attending support groups, I kind of understand but I really think it could be handled completely differently. I had even switched PCPs so I could have the surgery somewhere else where the wait wasn't as long.

Hang in there! You could either find a new place/new doctor for this or just follow the existing plan. It does go by faster than you would expect.

Put an action plan together for yourself--set some goals for each month that you can focus on that help you start to lose the weight prior to surgery (THis is the one thing that I did not do and I totally regret!!!!!). This will also help you pass the time faster but also move you towards your weight loss goal faster, too. You should probably begin their diet plan which I can only assume (but don't know for sure) that it is high Protein, low carb diet. I only assume that because that is how you will eventually eat. STart to get used to Protein shakes, too. They can be an acquired taste and there is nothing worse after surgery than trying these out and not finding ones that you have bought already that taste good.

You'll get there!

[mal0712 101]

One problem I'm having is no one seems to have a define requirement with my insurance and thay includes people that work for the insurance company lol I have tricare reserve select and I keep hearing thay some people didn't have to do a 6 month diet but the Web site says u have to! Some say you can go to a military hospital and skip many steps and some say they didnt. ???? so I'm trying to figure it all out but I've called the insurance twice and got two different replies from the workers!! So frustrating. I guess I should be thankful they atleast cover if

[Djmohr 6,965]

When I first started this process I was so frustrated with all the hoops a person has to jump through. As my bariatric nurse said to me, you could have one foot on a banana peel and one in the grave and our insurance company will still require all the hoops.

I too had a 6 month documented diet plan along with the physiologist appointments etc. then and only then was I scheduled for surgery and placed on a liquid diet.< /p>

Here's the thing, looking back I now believe that period of time set me up to build good eating habits so that I was completely ready to give up my old life. I ended up using that time to really get my head around this new lifestyle. By the time my surgery was scheduled (which by the way ended up taking 9 months) I was so ready and have never looked back.

I have seen folks that have not had that time sometimes struggle with the decision they made post surgery. The reality is changing your lifestyle is much harder than people think. Giving up the habits you once had that got you to this point requires time. For some people it is even harder.

If you take the time to get yourself ready, you may have more chance of success.

I also found the requirements were confusing and until I spoke directly with my insurance company and asked specifically what was required of me. That is when I was given a checklist by them of all the requirements.

It helped me get clear on the expectations. For me, moving doctors or clinics would not have made a difference in the process. It was my insurance company who made those requirements.

Good luck with your next steps and hang in there. All the jumping through hoops are worth it in the end.

Keep us posted!

[mal0712 101]

See that's part of the problem for me. If you tell me I have 9 months to prepare I can totally live with that and do what I have to Do. My problem is I have some saying that I don't have a wait time I just have to go get it done and others say no 6 months of dieting and tests. I know I sounded impatient lol bit honestly the time isn't as big of an issue as not knowing is for me. My bmi is incredibly high! I'm at like 55 or 56 ????... soooo mad at myself at this point

[esskay77 785]

I totally get it! I freaked out when I found out how long it would take. Especially because they didn't tell me up front!! It wasn't until I had gone through so many of the tests already so it really took the wind out of me. Definiltely try to get a checklist of what you need to do and when to see if that helps now that you know this. Frankly, it just sucks. No other way to say it.

[mal0712 101]

I have come to realize that lol you would think that with insurance things would be pretty to the point and in black and white. They were saying so many diff things than what the website had.

[enjoyinglife 313]

Hang in there!!!! I wish you all the best!!!

[MisforMimi 760]

It totally sucks, but for anyone reading this who up and decides they want WLS the best thing is to skip the doctor and call your insurance first. They set the rules we all have to play by, unless you're going for self pay in Mexico. I was working with a case manager through my insurance for a year prior to even thinking about calling anyone for a consult.

[colorfulperson 14]

I was told different insurance companies have different requirements. I'm on tricare prime south and they did require a medically supervised diet. I did one like two years ago and they accepted those records. The diet is 3 months. Then they wanted another three months of prep. I did all the nutrition, diet, exercise classes and had my evaluation. Now I have an update appointment next week and will schedule a surgery date. It's baby steps. They want you to mentally be able to handle the drastic life changes ahead. Just keep your patience and stay strong. And do your best. We all know your struggles and are here for you ????

[mal0712 101]

Thanks Trevor

mimi that mess was from the insurance company lol that's why it sucks so bad lol! If the rules are 6 months I'm so ok with that. But I keep hearing from others it's not :/

[della street 213]

Oh my, I don't know if I have the time or mental energy to tell the highlights of my insurance story, but here goes in the Cliff's Notes version:

--Hubby's work policy has specifically excluded WLS for at least 10 years

--Last fall (early Oct), I looked into purchasing a policy for just me on the Affordable Care Marketplace ("Obamacare")

--I'm in AZ, and all Marketplace policies must cover WLS -- not a well-known fact. I think it's 23 states ACA policies must cover WLS. Who knew? A fluke I found out...

--Found a policy thru BCBS of AZ that costs about $600/month, but we save about $200/month by not included me on hubby's work policy. Expensive, kind of, but $3500 out of pocket max, after that, all is 100% covered.

--Waited for open enrollment; purchased policy

--BCBS sent me bariatric guidelines -- said 8-week pre-op diet; covers band, sleeve or bypass

--Surgeon's office said have to do 6-month dr-supervised diet. Went round and round w/them since BCBS told me 8-week diet, not 6 months.

--Yada, yada, yada -- finally, BCBS told me that they accidentally gave me the wrong guidelines.

--UGH UGH UGH

--'Real' guidelines say 6-month dr-supervised diet (which I'd done elsewhere, so that was ok for me), but only cover band and bypass, exclude sleeve. I have no idea why.

--I get everything set up w/surgeon's office, have them change my file from wanting sleeve to bypass. They confirmed they done that so when submitted to BCBS, it would say bypass since they don't cover sleeve on my policy.

--Surgeon submits paperwork, I get call that my sleeve is approved. Yes, sleeve.

--Dead silence on my part, then I ask 'so they now cover sleeve on my policy?"

--Surgeon's office: "yes, they've specifically approved sleeve." I said, BUT IT'S NOT COVERED.

--Surgeon's office checks w/BCBS again and lo and behold, sleeve is not covered. they were extremely apologetic, but I could have had sleeve surgery and they could have said 'oops', you're not covered for that!!!!

--Plus, my surgeon's office had confirmed they'd changed my file to say bypass, but they obviously hadn't, and submitted me for sleeve (mistake) which BCBS approved (mistake)

--Bottom line: Bypass surgery scheduled later this month

--Other bottom line: YOU have to be in charge of everything and know what's covered, what's not, get it all in writing, and triple-check EVERYTHING. Not to discourage you AT ALL, just offering advice.

Feel so very fortunate to have bypass covered, but what a huge hassle!!!

I keep a spreadsheet of "to do's" and who I spoke with, etc. Names, dates, etc.

[mal0712 101]

That's one of the reasons I got on here was to see others experiences. Tricare Is a military insurance so I know it's widely used. I'm just not having much luck getting it figured all out yet

[della street 213]

Take it one step at a time and you'll get there -- hang in there, it's worth it!

[angelface811 100]

It can be a very difficult process and a confusing one. You can actually have your insurance company send you their policy regarding WLS coverage. This is what I ended up doing with my HMO because you are absolutely right some representatives will give you different answers. It was a lengthy group of papers but the full policy was there in black and white. I was also able to secure a health care advocate through my insurance company. I have actually been fighting to get this surgery since 2008 and I finally had my RNY in May 2014. I met all the requirements and went through a few different medical groups until I found a doctor and specialists who were willing to support my need for the surgery.

I did have to go through the 6 month program in which I had to fulfill my insurance requirements but also my medical group requirements. At first I was a bit annoyed because I had become so studied in the surgeries. I had to drive down to meetings at least once a week which for me was a 3 hour round trip. But I learned and observed several different things from my teachers and fellow patients. I even took a 2 month psychology class which was awesome. I have lost 90 pounds post-surgery and have 10 more to go to meet my goal weight. I have gotten rid of several conditions and medications. I was also recently asked to be a representative for my University's Bariatric Program at an upcoming health event. I have really developed a passion for helping those going through the process. So if you need any encouragement or I can help answer any questions feel free to ask. You sound pretty determined and that is probably the best quality you can have right now. Keep that passion, keep pushing, don't give up...❤️