heartonmysleevey

Great list Emily! I just jotted it down and will keep it handy.

If any others arise, I will put it up on here.

Thanks

So, it has now been 15 days and STILL WAITING. I just called the insurance company, and they said it usually never takes this long, but they have up to 30 days to reply. I am beyond frustrated. Has anyone else had problems with BCBS Federal- Texas?

Hopefully you get your "yes" real soon!

What happens if they don't give you your answer in 30 days?

Wishing you the best!!

Don't wish for a fast response. My information was submitted on Monday to Aetna and I have already received my answer today. My VSG was DENIED!!! I was under 40 BMI in late 2008-early 2009 when working with a trainer and dieting which was just one of my many successful cycles of dieting, exercise but without successful retention. Just another bump in this journey. Had I known the road would be so rough, I would have spent the extra money on some good touring tires.

Geez! I have Aetna too and I'm so so afraid of that first denial.

So now what? What will you do?

Best of luck with the next step.

I have already asked this one My doctor hasn't actually done that many, but he was up front and honest with me and has been doing bariatric surgery for many, many years so I feel comfortable with him doing the surgery. Thanks for the suggestion though!

Thats a relief! I still have a ways to go until I meet my DR. Thanks for this thread. I will writing all of these great questions down.

Morning NEVER changes.. my tummy doesnt take food in very well in AM so I always start with EAS AdvantEdge Carb Control premixed Protein drink.. 17 grams Protein - 110 calories and 6 carbs.. can purchase at any Walmart, WalGreens, Meijers and costco.

Mid Morning I have an Atkins Protein Bar

Lunch: 1/4 cup Fat Free Cottage cheese and 1/4 cup of meat, usually imitation seafood or cubed chicken breast

afternoon snack: Beef jerkey.. I found small 1.5 oz bag of very lean Jerky, 22 grams protein, 120 calories, 4 carbs

The above hardly ever changes, it allows me to hit 70 - 76 grams protein with only approx 600 - 700 calories and under 30 carbs!

dinner is always a portion of meat of some kind, always either grilled chicken, seafood, or fish.... Sometimes I will get Taco Bell pinto's & cheese, no red sauce add meat... Yum!!! Wendy's chilli is awesome and so filling!

That beef jerky sounds like a great snack. LOL I tried to just quote that part but I screwed up.

What brand is it and where do you buy it? Thanks

afternoon snack: Beef jerkey.. I found small 1.5 oz bag of very lean Jerky, 22 grams Protein, 120 calories, 4 carbs

That sounds like a great snack! if you don't mind me asking, what brand and where can I buy it?

Hey Sarah! I feel you. I think we all understand.

I think people are RUDE! I never ask another woman how far along they are. I could be wrong. I just ask ifthey plan on having kids or more kids.

Best of luck to you on this amazing journey. We are always here for you.

Good question!

One of my questions will be, what is the doctors track record? Me being over worried, I have to know about complications.

Best of luck to you.

Me too! I really hope we are still in the clear. I don't have a date yet, but my six month ends November.

My last weigh in was during my time of the month and I had gained 5 lbs. I could have died. Hopefully our next weigh in is better.

Good luck.

Best of luck on your journey with whom ever you choose.

I am hoping that I will be able to go to Dr. Brian B. Quebbemann, MD, FACS

Here is a link the website.

http://thenewprogram.com/default

Keep us all posted

I had surgery with Dr. Naim @ Advance Bariatric. His bedside manner is not great, but he's a great surgeon. His PA is very good to work with, so I don't mind his lack of "warm, fuzzy" skills. I have had no complications or complaints.

Thanks for that info. Good to know. I will be looking him up.

Congrats! I am switching to Aetna in September from health net. Keeping my fingers crossed.

Good luck and keep us posted.

Thanks for making me tear up! Great story and I could totally picture your dad. My dad is the same age too.

So happy for you both.

YAY! Super happy for your. Best of luck to you!

Yummmmmm! I willl be doing that before all of my tomatoes get spoiled. Thanks

Natashad---I'm right there with you. I started my 6 month diet in May as well. Can't wait to be on the losers bench and have a success story to share!

Whoa yeah whoa!!!! We are so close. Good luck to you.

Can't wait to be on the" losers" bench too.

Congrats to all of you!

Thanks Myrori!

I just got into my fitness pal. I LOVE IT! My dietician will accept it too. That makes my life so much easier. Now, if I can find the will power to lose weight and work-out.

My prayers are with you! Wishing you a speedy recovery.

*Hugs*

Thanks guys so so much. Once I get to see my surgeon I will let them know about needing a NUT.

Best of luck! Keep us posted.

Way to go!

I started my 6 months supervised diet back in February, so my last month is July...my company was sold July 1st and we have new Insurance as of July 1st which is Aetna

I had completed all the requirements was submitted to Aetna July 25th was approved on July 28th. So I think as long as you meet their requirements I don't think you will

have a problem,,, I

Wow that's really great! I hope I have the same luck.

I still haven't done anything like any of the other evaluations.

I should probably get all of those things out of the way.

Thanks.

Why do you have to do the six month supervised diet with Health Net? I have them also and that is not a requirement for the sleeve. Go look up their National Medical Policy - they no longer require a six month supervised diet for any WLS.

Yep - just checked to be sure. Their National Medical Policy was updated in Sept 2010 to no longer require participation in a supervised diet program prior to approval.

Your doctor might require it, but Health Net does not.

The only requirements for a sleeve from Health Net are:

BMI higher than 40 OR BMI higher than 35 with a severe co morbidity.

Less than 65 years of age.

You must be able to show them that a gastric band (lap band) or a gastric bypass will not be appropriate for you (ie...stomach/bowel issues, taking anti inflammatory meds, etc).

That's it. No supervised diet.

OMG! I could die. My six months would end in septemeber any way. Now that I'm switching it will be effective September 1 st. With Aetna.

Aetna wants 3 months so I'm hoping it just rolls over and I can get approved.

Thanks.

I had started my pcp supervised dieting last Sept By Dec, I had had the dietician consults and psych eval completed. My clearances with cardiologist and pulmonologists were also done by this time, however, I had to wait until Feb of this year to really push for getting surgery because that was when my 6 month period ended. Fortunately, I switched surgeons after having a miserable experience with the first surgeon--by a stroke of luck the ins referred me to the doctor I had originally seen in 2007 for the same problem--regained weight, and how to fix the bypass I had in 2001.

I have been on welfare and state Medicaid due to economic hardship. My surgery is covered through Medicaid, and I have followup care after my surgery 2 months ago. I feel swell! Have lost 30 pounds and continuing on the path of good health and wellness for my lifetime. I am so lucky!!!

You really are lucky!

Amazing story. Thanks for sharing.

Wow! All great information.

So far I have only seen my pcp and the dietician. In went to a seminar but never got my referral to see him. I haven't even decided if I wanted him or not. I haven't had an approval yet.

I will have an appointment in aug with my pcp. I have to wait till septemebr to ask for a referral.

How did you all get to meet with your surgeons? When did you get your referral?

The only records I have are my meetings with the dietician and my monthly weigh ins.

Thanks for giving my hope everyone.

Natasha