Kaiser Pleasanton

[dquintero 0]

I have an appointment for my first of I am sure many appointments for WLS. I have Kaiser and was wondering if any of you have dealt with Kaiser? I have heard they do not like to approve the surgery unless you have a BMI of at least 55. My doctor is sending me to the WLS oveview class so this sounds promising. I am considering Mexico if not approved by Kaiser.

[jvs92408 0]

You need to get hold of Kaisers medical criteria for bariatric surgery. It should be on their member website. They should be following the bariatric surgery society guidelines which state BMI over 40, or 35 if you have co-morbid conditions such as diabetes, respiritory conditions etc. Good luck!!!

[MacMadame 81]

I mostly know people going to the Fremont, Richmond and South SF Kaisers. None of them had to have a BMI of 55 or above.

[dquintero 0]

thank you both! My brochure says BMI of 55 or more. However, if there are other things like diabetes they will look at it on a case by case basis. I will keep my fingers crossed.

I have been fighting the battle of the bulge for 20 years ever since I graduated from high school! I now have a 2 1/2 year old and want to be around for her later on. I do not want to go on insulin, currently on pills for my diabetes, but sugars are on the high side now!

[momcof3 1]

I had my surgery done at Kaiser Richmond - you had to have a BMI of 40 or 35 if you had co-morbities. I know all of the northern CA Kaisers are in the process of becoming more consistent with their bariatric surgery guidelines. You can always appeal their decision.

[ivansmom 0]

I tried for 2 years to get approved through Kaiser. I finally gave up and paid for it myself in Mexico. I work for an insurance company, but I think that health insurance companies really are dishonest.

[dquintero 0]

Momof3 thanks. I have appointment on the 13th for the overview. I am eager to get this started.

[dquintero 0]

How did you like Mexico? I have a surgeon I will use if not approved by Kaiser. I am not waiting 2 years!

[dquintero 0]

I just checked my Kaiser Appointment page and they have scheduled me for the orientation on 12/14. My PCP put the request in on Monday, I did not think it would be that fast!! Hooray!! I am so excited!!

[jvs92408 0]

Great!!! This is the first step. Im about 2 months post op and struggling a bit as I can eat almost anything. I think I need another fill so I scheduled on in 2 weeks. I was expecting to not be hungry as soon as I was banded but this isnt the case. The messages here indicate that many people need a couple of fills before they really feel full, then the weight loss becomes more rapid. Im looking forward to that!!! Congratuations!!!!

[swishbc 0]

Hi, I had my orientation in Richmond and was told that you only get an orientation appt after the bariatric dept has gone over your medical record and you are qualified to have surgery. They told me that the only thing that would stop the surgery process is if you didn't pass the psychologists appt. They want to make sure we are all mentally healthy enough to undergo surgery and all the major life changes we will have to make.

The BMI requirements for Nor Cal Kaiser are 35 with co-morbidities or 40+ with no co-morbidities. I have heard that it's different in SoCal with 55 being a minimum, but I don't know anything about the SoCal rules.

I hope it all works out for you! Good luck. :cursing:

[momcof3 1]

Yes, that is true about Kaiser Richmond - all those who attend the orientation are in essence approved for surgery - the things that can stop surgery are the psych evaluation, not getting to goal weight, and possibly other medical issues that are uncovered by the ekg, the blood work, or the chest x-ray. Good luck on your journey.

[cndbarrett 0]

Hi, are you going to the orientation at Fremont on 12/14? I just checked my Kaiser appt page and saw that I am scheduled too! My doc just sent my referral last week!

[dquintero 0]

Yes, on sunday. I will be there. I am so excited!!

[cndbarrett 0]

I'm excited too! Have you heard that Fremont Kaiser doesn't like to do the lapband? Are you considering the bypass if they say no? My bmi is 40 also and I've lost six pounds and I want to get to 140 also!!--we're on the same track!:cursing: