Everything posted by buplee
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The Wait Will Drive Me Nutso!
The insurance specialist at my surgeon's office will be resubmitting my paperwork to Aetna. I was denied last week on silly technicalities which could have been easily handled. My original surgery date was 9/27, but now. I am hoping for an October or early November surgery date. I was going to appeal but that takes 45-60 days, so I decided to jump through some more hoops to try to get approved. Good luck to you all.
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Seeking A Dr That Will Fight Aetna - Aetna Says Surgery Excluded - But It Is Medically Necessary
I feel you pain. I have also Aetna POS and they denied me last week, and I work for a major insurance company that covers the employees for everything. I went through my required three months of nutrition counseling and then it took me three months to get my other clearances. The reason for my rejection was I was out of coverage with the nutritionist ( I should have had three more continued nutrition records, and they had no weight history from 2008-2012 ( a call to my primary care doctor could have solved that), no other comorbities ( no high blood pressure, high cholesterol, diabetes). I only had a total knee replacement and other joint issues all weight related- go figure. The insurance specialist at the surgeon's office was livid when Aetna denied me and had a rather heated call with the team. I have now completed another two of three nutrition counseling appointments and my weight history has now been provided to Aetna. The insurance specialist thinks I should be able to get approved this time, but just in case I am going to do a sleep study to check for sleep apnea. I have a tenacious wife, very supportive doctors, and an aggressive insurance specialist working on my behalf. I am keeping my finger crossed that I'll be approved and will get the sleeve in October. Good luck to you on you fight with Aetna and journey. I hope you find someone to fight hard for you.
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Web Sites To Purchase Food
I use a combo of Amazon subscribe and save and my Bariatric Pantry. There are some things that are cheaper on amazon and other items on mybariatricpantry.
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Where Do You Shop? Specifically: Online.
For Protein bars and shakes try mybariatricpantry.com. The have great flavors on shake powders ( Peanut Butter cookie, banana cream pie, strawberry cake, and great chocolate cake from Protizyme and Matrix). They also have fruit juice flavors from nectar. I also especially like the sample packs from mybariatricpantry.fom. I have tried a few which helped me determine which items I liked the most. For supplements, I use e-Vitamins and Amazon subscribe and save. I got a great buy one get two free on liquid vitamins from E-vitamins a few weeks ago. They also offer a great Calcium powder which can be sprinkled on food or mixed in any liquid of your choice.
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Web Sites To Purchase Food
For vitamins and supplements try e-vitamins. They have products that are the same as Bariatric Advantage at a fraction of the cost. I got a great price on calcium powder and caught a buy one get two free on liquid vitamins about three weeks ago.
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Web Sites To Purchase Food
I use My bariatric pantry. They have great protein bars and protein shakes. I especially like the Protizyme peanut butter cookie shakes as well as the Protizyme and matrix strawberry (tastes like a McDonald's shake). The other good flavore are chocolate cake and banana cream pie. They also have several sample packages so you can try the different items to determine which you like the best. I have not had anything from the site that was not good.
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Newbie Here
I was denied by Aetna last week after getting all of my clearances. I went to my Drs. for a letters of recommendation and they were all happy to help. They have been went me for years and want me to have wls as much as I do. I have been with my wife for 28 years and she is more than supportive. She has been with me through my weight swings. Should your insurance company deny your once, work with the insurance specialist at the surgeon's office to help you through the process. Should they deny you for a silly reason as they did for me, comply with the requests and try again. I am hoping to have my surgery late October. I have found the people on this forum very supportive and willing to share their respective experiences good or bad. This forum helped me to decide that I was going to go with the sleeve rather than the LapBand. Good luck to you on your journey.
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Vs Drama
- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
- 51 And Conflicted Between The Band And The Sleeve- Your Thoughts Wanted!
I want to thank everyone who replied to my post. I have decided and will be getting the sleeve once I am approved by Aetna.- Vs Drama
Just got bad news from the doctor's office. Aetna has denied my claim and delayed my surgery for a month said they need more data. I complied with everything they wanted and now this. Called Aetna and was told I could appeal but it would take 30-45 days. After years of delaying this I'm ready but can't. Is this why I pay my premiums for someone behind a desk to deny my claim? This for something that could have been handled by a call to my doctor. I am angry and very disappointed.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
Just got bad news from the doctor's office. Aetna has denied my claim and delayed my surgery for a month said they need more data. I complied with everything they wanted and now this. Called Aetna and was told I could appeal but it would take 30-45 days. After years of delaying this I'm ready but can't. Is this why I pay my premiums for someone behind a desk to deny my claim? This for something that could have been handled by a call to my doctor. I am angry and very disappointed.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
Thank you for such a detailed response. I will be meeting with my surgeon to go over my pre-op plan and think I am close to being converted.. I am so very happy I found this forum and the people who have replied to me.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
I am talking this over with my wife and starting to lean more towards the sleeve. I am happy so many of you have shared your thoughts and experiences and successes. I am still a little nervous about the procedure but getting closer with each post I read.- Jitters
Hi Doonab, I was like you and was all for the band, but have since changed my mind. I have friends who have the band and have lost a lot of weight. However, one just got married a few months ago and had an unfill for his honeymoon. He came back 25 pounds heavier. The other just had his port replaced due to an infection. There is good and bad for every procedure, but less maintenance with the sleeve. Do you research and have your surgeon help you with your choice. I wasted three years waiting to get to this point and can't wait for my surgery on 9/27. This forum is made up of good people who will support you through your journey. Good luck to you.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
I visited that forum. There are some very scary tales being told over there.- 51 And Conflicted Between The Band And The Sleeve- Your Thoughts Wanted!
You are right about my friends. It is my fear trying to talk me out of such a drastic procedure. I will have enough challenges without dealing with band issues. I want success this time not 20 more years of weight struggles. You guys are so great in helping me get closer to making the right choice.- 51 And Conflicted Between The Band And The Sleeve- Your Thoughts Wanted!
You are right. I guess it is my fear talking.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
How was the pre-op diet? I have heard so many stories about it. I'm sure I will be starting mine on Monday or Wednesday.- Does Anyone Else Have Problems With Their Coworkers?
I have made the decision not to tell my coworkers due to the issues I have read. My company allows me to work from home three days a week, so maybe they will think I am on another diet. I have gone up and down a few times since I have been there.- 51 And Conflicted Between The Band And The Sleeve- Your Thoughts Wanted!
I am the type of patient who goes into things heavily researched and informed. I like the benefits of the sleeve but hate the idea of losing so much stomach tissue. I also have awful reflux, I take prescription strength Prilosec daily, and hear it gets worse with the sleeve . I just want to make the right decision. I don't want to go the bypass route and I am no longer confident the band is for me. I guess I will make a decision after speaking to the doctor on Wednesday.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
I tried relying to each of your relies to my thread from my iPad but that did not work. Thank you all for sharing your respective experiences and decisions on why you are going with the sleeve. All of the experiences that have been shared with the band is helping to make my decision an easier and more informed one To all of you waiting for insurance approval may that approval come swiftly. I also hope that your respective pre-ops and procedure go smoothly. I was hesitant to share my thoughts because I am used to being alone in my mind. I am happy to hear from so many people who share my conflict and are working towards resolution. I have to tell my wife she is right as usual, but I should know that after almost three decades. To all who are post-op and all of us pre-ops- Our journey may not have been easy to get here and beyond, but I wish us all success and smooth sailing.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
Rachdreamz, good advice. My wife is all for the sleeve. I have a network of support from friends who have had wls and the support group. I will be making a decision when I speak to the surgeon on Wednesday. I have pretty bad reflux but no other comorbities other than my weight. The one thing I will not do is tell my coworkers. I have hear too many horror stories.- Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
Thank you. It's good to hear that I am not alone. My neighbor had the band and it took him 2 year to lose 80 pounds. He got married a few months Go went on a cruise and gained 25 pounds. I don't want a life of multiple trips to the doctor for fills. I have had two major surgeries in four years (total knee replacement and another surgery due to a staph and strep infection which effected the knee implant). I am nervous about having so much of a critical organ removed to gain control. - Procedure Conflicted. Thought I Wanted The Band But Now I Am Unsure- Maybe The Sleeve- Help!
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