Eastside Support

[Anna_Rachel 0]

Hello - I am in the process of being approved through my insurance company for lap-band. I am hoping to have a surgery date scheduled sometime soon. I was wondering if there are any local support groups - I live in Bothell, about 5 minutes from Evergreen Hospital. My surgeon is Dr. Kelly Clinch. So far, I have had wonderful responses from him and his nurse. My psych evaluation went well and I learned alot during the dietition evaluation. Any help would be greatly appreciated.

:biggrin2:Thanks,

Anna

[Lisa B 0]

Hi Anna - No answers for you, just a "me too!" :thumbup: I'm waiting on my insurance co. to approve surgery with Clinch as well. Finished the psych eval, nutritionist next week, hopefully surgery scheduled for this month (since Premera is dropping all ProAlliance docs, which is the group Clinch is affiliated with). If not Clinch then I'll be searching around for someone else equally convenient to me in Kirkland.

Anyway, good luck!

[Anna_Rachel 0]

Hi Lisa - You don't happen to work for Microsoft do you? I am in the same boat. I work for MS and I think I have to have surgery this month in order to have it covered under MS Premera. If that's the case, I'll also be searching for another doctor. I am gone the week after next, and I heard that Clinch is gone the last week in July. August is so busy with work, that I really wanted to wait until September to go under the knife. Anyways, thanks for replying. It would be nice to have some support through this. My family and friends are supportive, but don't understand the struggle I am going through. I guess I could be considered a lite-bander, I'm not HUGE, by any means. But my BMI certainly suggests I need a weight makeover. Happy 4th!!

Anna:thumbup:

[Lisa B 0]

Hi Anna - Yep, Microsoft. :thumbup: I hadn't heard Clinch would be gone for a week, but what the nurse (Moira?) did tell me that if Premera approved the surgery and they (Clinch's office) said they were going to do it in July, then even if the surgery didn't take place until August 10, it would be covered. I have my doubts on that one, however! Even when I asked Premera if followups with a surgeon who did some hip surgery on me would be covered, they said no. Probably depends which benefits person you get as to what answer you get on any given day! In general insurance = groan. :thumbup:

Cheers,

Lisa

[Lisa B 0]

Anna - I just found out I've been authorized for the surgery, and what they said (other than the correct insurance term is "not denied" - how positive of them ) is that I am authorized to have the surgery with this doctor anytime between July 10 and October 10. So it is covered anytime between those dates.

I'd been calling Premera every day and today got the bright idea to call the MS Benefits person for help. Altho it sounds like the very sweet guy I talked to yesterday at Premera was the one who lit a fire - they wouldn't give him any answer yesterday, but he did badger them for me.

And it worked, because I'm approved, I'm approved, I'm approved!

Just have to get through MGX now ...

[Anna_Rachel 0]

Hi Lisa - Thats GREAT!!! I've also been approved, but they've told me July 31st is the cutoff. You have the same insurance I have right (Premera) so I am going to ask Moira what we can do to extend my limit so I can have surgery sometime in September. I've been calling them everyday but it takes them a day or two to get back to me (which is really annoying). Anyways, I am really really happy for you. Let's stay in touch - it would be awesome to have a "buddy" to go through this journey with.

On a side note - which building do you work in? I am in B24. I am a M&A HR Coordinator. I started end of March and I absolutely love what I do.

Take care!

Anna:smile2:

[WishUponABand 0]

Hello - I am in the process of being approved through my insurance company for lap-band. I am hoping to have a surgery date scheduled sometime soon. I was wondering if there are any local support groups - I live in Bothell, about 5 minutes from Evergreen Hospital. My surgeon is Dr. Kelly Clinch. So far, I have had wonderful responses from him and his nurse. My psych evaluation went well and I learned alot during the dietition evaluation. Any help would be greatly appreciated.

:biggrin2:Thanks,

Anna

Hi :thumbup: I know you posted this a few weeks ago but I tried searching for Dr. Clinch and I found your post I am waiting my first meeting with Dr. Clinch on the 30th! :scared2: So far I've seen the Nutritionist, and my Physician wrote me a referral letter. I don't know what to expect with my first consultation w. Dr. Clinch but I am more then excited to see! Maybe we can all support eachother since we're so close! :frown:

[🅺🅸🅼🅼🅸🅴🅺 296]

Hey guys! I'm just stopping by to ask what Premera in WA requires for approval? It seems like they put you thru more hoops than MS insurance down here in Texas. My FTE friend was approved in literally just a couple days after doing all of her testing (chest xray, sleep study, etc..) Do you have to have obesity history documented by a physician over time? If I do end up having to move to WA, there's nothing like being super prepared :eek:

[WishUponABand 0]

Hi,

I have United Healthcare however everyone I have spoken too on here (all sorts of insurances and self pays) have to have at liest 5 years of supervised and un-supervised weight loss attempts and 5+ years of obesity history. a BMI of 40+ or a 35+ BMI with co-morbidities. Hope this helps. *~*Steph*~*

[Lisa B 0]

Don't know about Anna, but MS Premera approved me in a bit less than two weeks. BMI of 40, no co-morbidities, I have done a weight-loss program via Premera a couple of years ago (lost 54 lbs., gained back 74 - arg). I didn't find it difficult at all. YMMV

[Anna_Rachel 0]

I was the same. MS Premera approved me in about a week or so. I also don't have any co-morbidities, just BMI of 41 and fat :thumbup: I might be changing doctors however. I found one at Overlake and he comes recommended from several people including my OB.

[🅺🅸🅼🅼🅸🅴🅺 296]

That's pretty much my issue. My BMI is high but I don't have any co-morbidities yet. I was approved with United Healthcare at the beginning of the year but my employer had a WLS exclusion that took forever for me to find out. I'll definitely be keeping this thread in case I need to reference it in the future.

[OnTheWay to Thin 0]

Hi I am looking to go with Dr C too, did you have surgery and if so what was your experience with him like?

[Anna_Rachel 0]

Yes, I did have surgery with Dr. Clinch. Very happy with the outcome....although alot of that was my work, not his. I didn't have any issues post surgery. Now that Premera has dropped him, I have to pay $120 every time I go for a fill. I will be finding another doctor who my insurance does cover for all future fills.