della street

@@Melanie36 Yea for you!!!!!

@@bellabloom I used to go to just such a gym, "Naturally Women" -- it closed several years ago, unfortunately --

@@highdesertblue RNY Jan. 29th -- at Scottsdale Healthcare, the nutritionist works for them, so that's really convenient. They have a psychologist that consults w/them, so saw him in their office. Almost a "one-stop-shop", lol -- I'm getting really nervous, but super-excited too! I've heard really good things about your surgeon, he's been doing this a long time --

@@highdesertblue Who are you seeing in Phoenix? I'm having surgery at Scottsdale Healthcare... Oh duh -- I see on your profile, Hilario Juarez -- St. Luke's, right?

@@MrsB2007 You're right, not far at all! My RNY is Jan 29, how about you?

Anyone else in Scottsdale, AZ?

Hi there, re "Obamacare" -- depends on what state you're in. There are 23 states whose Affordable Care Act policies are required to cover WLS, of course w/diff out of pocket max, deductibles, etc. See this link - -- you may have to copy and paste the link, doesn't look like it's 'hot' -- http://www.bariatricpal.com/topic/282782-affordable-care-act/ I'm in AZ, and my ACA policy covers WLS, but it depends on where you live. It's the same with a number of other provisions for things like fertility treatments, autism coverage, and many more. States wanted control, so it varies by state.

@@BLERDgirl She'd need to check on open enrollment dates for the Exchange as well as with her HR department about it -- not sure, but purchasing on the Exchange sure as heck worked great for me -- yep, a little pricier than we were paying with me included on hubby's policy, but not so much that we can't swing it with some belt-tightening, no pun intended, lol. Of course, I have to pay the monthly premiums, but then after my out-of-pocket max, it's 100% covered.

Lipstick Lady is right -- if it's a company policy, the company decides what w/be covered and what w/not -- that's why, for example, two different BCBS plans can be one w/coverage; one without.

They very well may not cover the bypass either -- hubby's policy for many years specifically and categorically excluded any kind of weight loss surgery. And I was told almost word-for-word the same thing "you could be in danger of imminent death and it's still excluded". So I definitely feel for you -- What I did was this year, I purchased my own policy separately from husband's -- 23 states are required by law to cover weight loss surgery in the Affordable Care Act ("Obamacare") polices. Fortunately beyond all measure, my state, AZ, is one of them. Here's more info: http://www.bariatricpal.com/topic/292754-does-obamacare-cover-weight-loss-surgery/

@@wildflowergirl Just a suggestion--have you thought about appealing? Explain all that and see what they say - the worst they can do is say no again -- but it might be enough, along w/a letter from your doctor, to have them approve -- best of luck!

@@BloomingLotus Just a 2-day pre-op diet -- light foods two days before, then clear liquids day before. My surgery is sched for 8 am on the 29th -- what time is yours? What kind of pre-op diet do you have to do? And yes, excited! terrified! happy! scared! all of the above! lol

@@BloomingLotus I see you're having sleeve on 1-29 -- I'm having RNY also on 1-29 -- we can count down together ) Congrats!

I'll double-down on Quest bars -- just had a choc chip cookie dough one - major yum and 21 grams of protein. You can buy them by the case (12) on Amazon, or I get them at Sprout's (like Whole Foods if you don't have Sprout's where you live). Then you can buy them individually and try a few flavors. Hint: I purchased a full box/unopened at Sprout's the other day (12 bars) and the cashier gave me the "case" discount of 10%. Who knew? ) (they work out to about $2.25-$2.50 a bar, so not cheap, but worth it to me so far...)

My RNY is scheduled for Jan. 29th!

@@Sharon1964 Thanks -- great info -- I did get a letter approving sleeve -- I'm assuming I'll get another one disapproving sleeve and approving bypass. The letter says "we've approved the above services. Approval is based on what we know about you, your benefit plan and the planned service. This approval is not a promise of payment. We can't be sure about payment until we get a claim telling us what your provider really did for you. Once we get the claim, we can tell if the service is covered under your plan." Oy.

@peteyrulz -- lol! Best of luck to you too!!! Hang in there! I just keep thinking someday, I can be hanging on a sunny beach and feeling normal-looking and remembering all this as being part of the distant past...

Waiting is the WORST. Because your life is totally in the hands of other people doing their job. Here's a very brief overview of my insurance saga - reposted from another forum: I don't know if I have the time or mental energy to tell the highlights of my insurance story, but here goes in the Cliff's Notes version: --Hubby's work policy has specifically excluded WLS for at least 10 years --Last fall (early Oct), I looked into purchasing a policy for just me on the Affordable Care Marketplace ("Obamacare") --I'm in AZ, and all Marketplace policies must cover WLS -- not a well-known fact. I think it's 23 states ACA policies must cover WLS. Who knew? A fluke I found out... --Found a policy thru BCBS of AZ that costs about $600/month, but we save about $200/month by not included me on hubby's work policy. Expensive, kind of, but $3500 out of pocket max, after that, all is 100% covered. --Waited for open enrollment; purchased policy --BCBS sent me bariatric guidelines -- said 8-week pre-op diet; covers band, sleeve or bypass --Surgeon's office said have to do 6-month dr-supervised diet. Went round and round w/them since BCBS told me 8-week diet, not 6 months. --Yada, yada, yada -- finally, BCBS told me that they accidentally gave me the wrong guidelines. --UGH UGH UGH --'Real' guidelines say 6-month dr-supervised diet (which I'd done elsewhere, so that was ok for me), but only cover band and bypass, exclude sleeve. I have no idea why. --I get everything set up w/surgeon's office, have them change my file from wanting sleeve to bypass. They confirmed they done that so when submitted to BCBS, it would say bypass since they don't cover sleeve on my policy. --Surgeon submits paperwork, I get call that my sleeve is approved. Yes, sleeve. --Dead silence on my part, then I ask 'so they now cover sleeve on my policy?" --Surgeon's office: "yes, they've specifically approved sleeve." I said, BUT IT'S NOT COVERED. --Surgeon's office checks w/BCBS again and lo and behold, sleeve is not covered. they were extremely apologetic, but I could have had sleeve surgery and they could have said 'oops', you're not covered for that!!!! --Plus, my surgeon's office had confirmed they'd changed my file to say bypass, but they obviously hadn't, and submitted me for sleeve (mistake) which BCBS approved (mistake) --Bottom line: Bypass surgery scheduled later this month --PS: just received "approved for sleeve" letter from BCBS in the mail. OY!!! --Other bottom line: YOU have to be in charge of everything and know what's covered, what's not, get it all in writing, and triple-check EVERYTHING. Not to discourage you AT ALL, just offering advice. Feel so very fortunate to have bypass covered, but what a huge hassle!!! I keep a spreadsheet of "to do's" and who I spoke with, etc. Names, dates, etc.

Take it one step at a time and you'll get there -- hang in there, it's worth it!

Oh my, I don't know if I have the time or mental energy to tell the highlights of my insurance story, but here goes in the Cliff's Notes version: --Hubby's work policy has specifically excluded WLS for at least 10 years --Last fall (early Oct), I looked into purchasing a policy for just me on the Affordable Care Marketplace ("Obamacare") --I'm in AZ, and all Marketplace policies must cover WLS -- not a well-known fact. I think it's 23 states ACA policies must cover WLS. Who knew? A fluke I found out... --Found a policy thru BCBS of AZ that costs about $600/month, but we save about $200/month by not included me on hubby's work policy. Expensive, kind of, but $3500 out of pocket max, after that, all is 100% covered. --Waited for open enrollment; purchased policy --BCBS sent me bariatric guidelines -- said 8-week pre-op diet; covers band, sleeve or bypass --Surgeon's office said have to do 6-month dr-supervised diet. Went round and round w/them since BCBS told me 8-week diet, not 6 months. --Yada, yada, yada -- finally, BCBS told me that they accidentally gave me the wrong guidelines. --UGH UGH UGH --'Real' guidelines say 6-month dr-supervised diet (which I'd done elsewhere, so that was ok for me), but only cover band and bypass, exclude sleeve. I have no idea why. --I get everything set up w/surgeon's office, have them change my file from wanting sleeve to bypass. They confirmed they done that so when submitted to BCBS, it would say bypass since they don't cover sleeve on my policy. --Surgeon submits paperwork, I get call that my sleeve is approved. Yes, sleeve. --Dead silence on my part, then I ask 'so they now cover sleeve on my policy?" --Surgeon's office: "yes, they've specifically approved sleeve." I said, BUT IT'S NOT COVERED. --Surgeon's office checks w/BCBS again and lo and behold, sleeve is not covered. they were extremely apologetic, but I could have had sleeve surgery and they could have said 'oops', you're not covered for that!!!! --Plus, my surgeon's office had confirmed they'd changed my file to say bypass, but they obviously hadn't, and submitted me for sleeve (mistake) which BCBS approved (mistake) --Bottom line: Bypass surgery scheduled later this month --Other bottom line: YOU have to be in charge of everything and know what's covered, what's not, get it all in writing, and triple-check EVERYTHING. Not to discourage you AT ALL, just offering advice. Feel so very fortunate to have bypass covered, but what a huge hassle!!! I keep a spreadsheet of "to do's" and who I spoke with, etc. Names, dates, etc.

My surgeon doesn't do many bands any more and he, too, has been doing surgeries a long time. Too many revisions and not enough long-term success. That said, there are some dedicated 'band-sters' w/their own forums, both on here and elsewhere...

Congrats! I'll be there in 3 weeks!

Just got confirmed RNY surgery date of Jan. 29th -- so excited, scared, nervous, etc! Mostly just HAPPY to have made it this far on this years-long journey!

I guess I'd ask (in a nice way...) the reason for their inquiry -- I can't imagine a legal reason for that, but I'm not a HIPAA expert or a lawyer or an HR person, so I really don't know -- but that seems troubling to me...

@@FOXYLADYA Agree -- get a second nutritionist opinion--was this nutritionist associated w/a bariatric surgeon? Because your BMI is about 40 or so, which 'counts' in most bariatric guidelines I've seen --