Help!

[britt_lewis2011 46]

I'm new to this whole process. I signed up for my seminar this past Thursday and was all excited. Then on Friday I decided I would call my insurance and see what my coverage was. Turns out it's not covered at all. Total let down. I'm only 24 and weigh 364 so it took a lot of courage to even make the appointment. I carry my weight we'll and am completely happy in my life but I want to get healthy. A lot of diseases run in my family and I know I'm headed down that road if I don't change something. What are my options now? I see that it's cheaper to go to Mexico but how do you make that decision? When you say that out loud it raises an eye brow.

[samuelsmom 670]

There are a lot of people on this forum who went to Mexico and have had great results. @@JamieLogical may be able to give you some guidance as she has done a lot of research in that area.

Good Luck to you. Congratulations on making that appointment.

One more thought- have you looked into changing insurance? You could start a plan like weight watchers now which has the weekly weigh ins and keep a diary of your activity and by the time you had the new plan you would have some of the requirements met...

[britt_lewis2011 46]

No I hadn't thought about changing insurances. Not sure where to start with that. My current insurance is through my employer. Ive lost 40 lbs this year and gained 20 back because I quit watching what I ate and going to the gym. I went to a weight watchers meeting once but didn't like the crowd. I used my fitness pal.

[Sharon1964 2,530]

Go to your employer and tell them about your desire to get healthy. Ask them to investigate getting a rider that will cover weight loss surgery. Over your lifetime, paying for the surgery will be far cheaper than paying for your healthcare for weight-related problems.

[samuelsmom 670]

Each year there should be an "open enrollment." You can check all of the plans your employer offers then. I also heartily agree with the other suggestion of talking to your employer about adding this coverage.

I had suggested weight watchers because a lot of plans require a certain amount of supervised visits with weight recording and many of them will accept weight watchers documentation. You can also go to your family doctor who can order a nutritionist consult and start supervised visits. The whole point is to get the required visits started so that you will be ready by the time the insurance gets worked out. More and more insurances are starting to cover this surgery because of the evidence that this is the most effective treatment for morbid obesity.

One more thing, since you are under 26 you might want to look into getting on your parents health insurance. You can find more information at http://www.hhs.gov/healthcare/rights/youngadults/

Good luck!

Edited June 1, 2015 by samuelsmom

[britt_lewis2011 46]

I have the best insurance my employer offers. As for being on my mothers insurance that's not an option. I'm married and I can't get on my husbands. If I didn't work i guess Obama care could possibly be an option but I'm not sure if he makes to much. Plus I really don't want to quit my job and I don't see me getting a new one anytime soon.

[nikkiperezcassar 36]

I found out he hard way that employers can chose to opt of out bariatric coverage on all of their plans. Apparently it's more expense premiums for them. I ultimately ended up changing employers for that and other reasons. Now I'm

On my 6 mo documented diet plan with BCBS and the coverage seems really good. I looked into outside policies but with all these crazy insurance changes I had to stay with my employer instead of purchasing a private policy. The cost just wasn't worth it. Good luck to you though! I hope you find a solution that works!

[Miss Mac 6,262]

While you are waiting and hanging out here for support, you can initiate the following steps that most of our plans have us do for our pre-op preparations.

Drink no calories.

Drink Water until your eyeballs float - 64 - 80+ ounces per day.

Don't eat anything made in a factory. You can do this by shopping the perimeter of the supermarket and avoid the aisle unless you need a spice or paper towels...that kind of stuff.

Eat at least 60 ounces of Protein per day, and at any meal, eat your Protein first - then veg - then fruit.< br />
Dessert should be something like an apple, not apple pie with two scoops of ice cream.

Avoid sugar, grease, and salt as much as possible. Eating clean will help you discover the real taste of natural food. If it weren't for sugar, grease and salt, McDonald's would have no business. When I gave up candy bars and started eating dark chocolate, I realized that it wasn't the chocolate I missed - it was the sugar.

Try to wean yourself off of soda and diet soda. Most bariatric plans discourage soda pop and anything with bubble post-op.

Reduce starchy carbs like bread, flour, sugar, rice, noodle, biscuits, white potatoes, macaroni, spaghetti etc.


So what is left to eat? meat, eggs, cheese, Beans, Peanut Butter, yogurt, cottage cheese, nuts, and fresh fruits and non-starchy veggies. You can adjust your current recipes to reduce carbs. The World According to Eggface is a good place to start. We have a forum here for recipes. Also, Sparkpeople.com and Myfitnesspal.com.

Many of us use Myfitnesspal.com for logging our food every day. It is really an eye-opener if you are honest with yourself about what you eat.

Weigh and measure your food to acurately acknowledge your actual portion size. There is a scientific principle that says, "You cannot control that which you do not measure."

Exercise where you can. Move your body every day. Don't become part of the sofa. I have 35 exercise DVDs of all kinds and variety from bedfast exercises to chair exercises, to Zumba, Hip-Hop Abs, Pussycat Dolls, Bollywood, Salsa, Strength Training and Toning, etc..... and ridiculously enough, my favorite is still Richard Simmons Sweatin' to the Oldies. If you can't afford videos, crank up some loud music and dance like nobody is watching, or take wal There are also a TON of Youtube videos with exercises you can follow.

Now is a good time to make regular visits to a physician so that your weight can be monitored. Many plans require several months of medical diet supervision as a pre-requisite for approval. My plan was two years. You may also have to provide a list of all the different diets that have failed you.

I wish you best and hope that you can have your surgery with an uncomplicated recovery. Good luck, and visit us often. And just so you know, opinions and tact will vary here.

[juno5 30]

My ins does cover wls. However if I am not approved I will most likely be taking a trip to Mexico with my husband....I'm on edge waiting to see if I'm even going to be approved. I'm in the very beginning of the entire process

[jaxmom1974 53]

I found out he hard way that employers can chose to opt of out bariatric coverage on all of their plans. Apparently it's more expense premiums for them. I ultimately ended up changing employers for that and other reasons. Now I'm

On my 6 mo documented diet plan with BCBS and the coverage seems really good. I looked into outside policies but with all these crazy insurance changes I had to stay with my employer instead of purchasing a private policy. The cost just wasn't worth it. Good luck to you though! I hope you find a solution that works!

It's very true. Our insurance has a bariatric surgery exclusion. The company gets to pay lower premiums when they exclude certain things.

[BLERDgirl 6,417]

The "best insurance your employer offers" may not have be the one you need. If you want surgery in the US you want insurance that covers WLS. Before you switch read the fine print and find out what types of WLS it covers just to be safe.

Surgery in Mexico is a good and safe alternative as long as you do your homework. Several successful sleevers on these boards have gone that route. Do a search for Mexico. You will find many usernames. Most of great about chatting and answering questions.

You mention you feel off the wagon due to not watching what you ate. Please keep in mind that even with WLS you have to watch what you eat in order to get the most benefits. It's a good habit to get into now as you contemplate the lifestyle changes that come with WLS.

[BLERDgirl 6,417]

While you are waiting and hanging out here for support, you can initiate the following steps that most of our plans have us do for our pre-op preparations.

Drink no calories.

Drink Water until your eyeballs float - 64 - 80+ ounces per day.

Don't eat anything made in a factory. You can do this by shopping the perimeter of the supermarket and avoid the aisle unless you need a spice or paper towels...that kind of stuff.

Eat at least 60 ounces of Protein per day, and at any meal, eat your Protein first - then veg - then fruit.< /p>

Dessert should be something like an apple, not apple pie with two scoops of ice cream.

Avoid sugar, grease, and salt as much as possible. Eating clean will help you discover the real taste of natural food. If it weren't for sugar, grease and salt, McDonald's would have no business. When I gave up candy bars and started eating dark chocolate, I realized that it wasn't the chocolate I missed - it was the sugar.

Try to wean yourself off of soda and diet soda. Most bariatric plans discourage soda pop and anything with bubble post-op.

Reduce starchy carbs like bread, flour, sugar, rice, noodle, biscuits, white potatoes, macaroni, spaghetti etc.

So what is left to eat? meat, eggs, cheese, Beans, Peanut Butter, yogurt, cottage cheese, nuts, and fresh fruits and non-starchy veggies. You can adjust your current recipes to reduce carbs. The World According to Eggface is a good place to start. We have a forum here for recipes. Also, Sparkpeople.com and Myfitnesspal.com.

Many of us use Myfitnesspal.com for logging our food every day. It is really an eye-opener if you are honest with yourself about what you eat.

Weigh and measure your food to acurately acknowledge your actual portion size. There is a scientific principle that says, "You cannot control that which you do not measure."

Exercise where you can. Move your body every day. Don't become part of the sofa. I have 35 exercise DVDs of all kinds and variety from bedfast exercises to chair exercises, to Zumba, Hip-Hop Abs, Pussycat Dolls, Bollywood, Salsa, Strength Training and Toning, etc..... and ridiculously enough, my favorite is still Richard Simmons Sweatin' to the Oldies. If you can't afford videos, crank up some loud music and dance like nobody is watching, or take wal There are also a TON of Youtube videos with exercises you can follow.

Now is a good time to make regular visits to a physician so that your weight can be monitored. Many plans require several months of medical diet supervision as a pre-requisite for approval. My plan was two years. You may also have to provide a list of all the different diets that have failed you.

I wish you best and hope that you can have your surgery with an uncomplicated recovery. Good luck, and visit us often. And just so you know, opinions and tact will vary here.

All VERY good points. A few other things I started doing in anticipation of WLS that made post-op life easier.

• Start exercising even if it's no more than a daily 30+ minute walk
• Practicing eating slower. Take smaller bites and chew ALL food until it dissolves in your mouth.
• Increase your protein intake. Try to make that protein come from as "clean" a source as possible. (not processed foods).
• Start drinking Water or increase the amount of water you drink.