kczar

Because of the gaps in insurance, I saw one doctor two years ago and my PCP in January. They may take that but I'm not sure. I'll check with my surgeon's office and insurance to be sure.

I double checked the list of requirements from my insurance yesterday, and it specifically states that I need documentation of a BMI 40 or more for at least a six month period. That's because I only have one co-morbidity. Oh well, I'm going to continue working on my eating habits and working out, but I'm not going to push myself to lose much weight.

So sorry about that, but I would hope your surgeon is looking out for your best interests. I'm kind of in the same but (but with a much higher BMI). My insurance requires documentation that my BMI is at least 40 over a six month period. I've been working with the nutritionist and really wanted to try and lost a good bit of weight before surgery. Then I realized that if I lose more than 22 pounds I would be under the requirement and they wouldn't cover it. So, I'm going to continue to work on my eating and drinking habits in preparation for my post op life, but I'm definitely not going to try and lose much weight. It's sad that this is part of the game that you must play in order to get the surgery. Best of luck to you and I hope you keep posting here anyway.

Congratulations on getting your date! I'll be interested in hearing other people's input about this. I have to do the six month mambo too, so I feel your pain.

Woohoo! Congratulations. Keep us posted and good luck on the pre-op diet.

Thanks for the input, I'll double check when I go to my NUT appointment tomorrow. Webchickadee, it really doesn't make any sense for them to not cover it. It's like policies that don't cover birth control, but will provide prenatal and child coverage. Isn't that a tad more expensive? I've been without insurance for ten years (work for a small startup company) and when I had to go to the emergency room with a gallbladder attack last September, I started checking into insurance in earnest. My employer was willing to bump my salary to cover the cost of individual insurance but I couldn't get any! Why? Because of my weight. I had no pre-existing health conditions other than my gallbladder but no one would touch me. Fortunately, there is a government funded program for people like me. I was able to get on starting in January and get my gallbladder removed. That meets my OOP maximum so this is my medical year! No matter what anyone says about "Obama Care", if it wasn't for healthcare reform, I would still be without insurance and probably saddled with a 20-30k bill for emergency gallbladder surgery. Good luck with your surgery and keep us posted! I've read lots of good things about Dr. Kelly and surgery in Mexico in general.

I've never used the chat function, but I just hit the Chat button in the header and it loaded. It does say that it uses Flash so if you're on a IPhone or something it may not work. Good luck!

Congratulations on your date!

Congratulations, April!

Congratulations and happy surgiversary! Keep it up.

Hope you feel better soon and can get started on your new life!

Way to go! I'm glad you're doing so well. Take it easy and keep us posted.

Good luck! It's a bunch of hoops you have to jump through but they all lead to a successful surgery.

Have you tried Ben Gay or maybe some of those disposable pads that heat up? Good luck and stop overdoing it!

Congratulations!

Umm, not sure about that Pogi. Maybe in California, but I don't think that's the case everywhere. I'm in Texas and this year I had gallbladder surgery and an endoscopy, both of which were subject to deductibles and copays. Different doctors, different hospitals. With each doctor, I had to pay a down payment based on the projected copay as determined by my insurance. Hospitals, same thing. They contacted me with my estimated portion and I had to make a down payment and agree to set up a payment plan once insurance had been filed and my balance due was finalized. In my initial visit to the surgeon to discuss WLS, I met with the insurance coordinate and given the projected copay I would be responsible for and told that payment was to be completed before surgery would be scheduled. Lucky for me my gallbladder and endoscopy covers my OOP maximum so my sleeve will be free! Just wanted to share my experience with insurance to give another perspective.

Your surgery may cover all of your OOP, which means that you wouldn't owe anything on your husband's stay. Make sure to double check on that since his stay was before your surgery. If nothing else, they will refund anything you pay over your maximum. Good luck!

Have you called your insurance to confirm? I called mine (three times!) to double check all their requirements. Sometimes you need to ask to speak to someone who specializes in bariatric requirements. Ask them to e-mail you the requirements and then take them to the office manager. She can't (or shouldn't) refuse to submit your paperwork. Is she the actual insurance person or just thinks she knows everything? Best of luck, honey. It sounds like with your other health issues that you should be approved. Keep us posted.

If you have cable, they usually have different workout programs available on demand. They will rotate but there's usually at least one cardio workout, fat burning, toning and yoga program available. Your kiddo(s) can do it with you! You'll get toned and they will learn healthy exercise habits.

I've been trying to lose a bit of weight before my surgery (six month wait due to insurance.) I've been reducing my calories and even started upping my Protein. This morning I realized that if I lose more than 22 pounds during my supervised diet, my BMI will drop below 40 and I wouldn't qualify for surgery. I "only" have one co-morbidity and my insurance requires two if you're BMi is below 40. Although I'm thankful insurance will cover it (and I've met my out of pocket maximum due to gallbladder surgery), it sucks that I could be penalized for being successful. So I guess I'll set a goal to lose 10-15 pounds until my paperwork goes in, which will either be end of July or end of August. I'm not sure when the insurance asks for a six month monitored diet if six visits with the NUT counts or if I have to do seven. Anyone out there know?

I was told thirty minutes before and after but that might be pre op. I asked my NUT about the no drinking thing. She said there are two main reasons: first, it could fill you up and prevent you from getting your food in. Secondly, it will prevent the food from staying in your stomach and you won't have that full feeling.

First of all, congratulations on finding a job you love. A lot of people aren't that lucky. You're right, it can be a lot cheaper to eat trashy food. Ramen and mac and cheese cost a lot less than tilapia and fresh produce. But the cost to your health is tremendous. Try compromising. Maybe regular fruit instead of orrganic. Frozen steamer bags of veggies can be pretty cheap but provide quality. You may not be able to buy premium products right now, but you can still make healthier choices. Best of luck to you and hang in there!

JG, if you have an Ulta in your area, they sell Nioxin as well. It works for a lor of people but not everyone. Hope you're one of them!

Congratulations on your decision! If you're looking for a fitness center but are self conscious (I certainly am!), I would recommend looking for a Planet Fitness center near you. They're the ones with the "I pick things up and put them down" commercial and they tout themselves as a judgment free zone. I joined and it really is! It costs $10 a month and you can cancel any time. They have a lot of equipment and even have a thirty minute workout section ala Curves. I liked it because it was a low cost introduction into working out without having to deal with a bunch of intimidating hot bodies.

So happy to see something from Taco Bueno! It's one of the places that would be tough to give up. Do you eat the whole tortilla as well? What about protein shakes? Are they pretty much out of the picture? I hope to have the surgery in August/September. Thanks!