Lexigurl82

I would say switch surgeons. As soon as my surgeon's office received my approval they called me to schedule my surgery. The only thing I haven't gotten yet was pre-op instructions but I won't bug them since my surgery is 6 weeks from now. Before you switch, call your insurance carrier and make sure that the switch will not interfere with the approval you already received and explain to them as to why you are making the switch. Make sure you get the first name and last name initial of the reps/supervisors you speak to and a reference number if they have one. I work in insurance and authorizations... this is to protect you in case someone says later down the road says that they never told you that you could switch, etc. Good luck and keep us posted on what happens!

I have Aetna but I never knew of a deadline...are you sure that was the real reason for denial?

it depends on your insurance. I had my first visit with the surgeon in July. Needed 3 monthly visits with my NUT. The surgeon's office gave me a list of what I needed, which was a psyc eval, chest x-ray, EKG and pulmonary function test. I received my approval from insurance on 10/23/2015. I scheduled my surgery for December 2nd. I could have had the surgery before Thanksgiving but I have to prepare things financially before I could do the surgery.

Can you give us an update on this? My surgery is scheduled for December 2nd and I too do not know any costs. I've met my deductible for the year already. Did you have to pay anything up front before surgery?

I have Aetna and it took a week for them to approve me. My surgeon has a wide open schedule and could do the surgery as soon as next month, however I have a lot to do as far as preparing for the surgery financially, therefore I scheduled my surgery for the 1st week of December. Good luck!

if all else fails, try going back to the doctor you saw years ago for the sinus infection. The reason I say that is because the PCP who is writing my letter, I have not been in their office for at least 2 years. I went back to her and explained that I was reconsidering surgery and I have an appointment to come into the office for bloodwork on next week. Her medical assistant said once I come in and do bloodwork, they will send my surgeon a clearance letter for surgery. Good luck!

@@acyum2008 thanks! have you heard back from Aetna? Don't be afraid to bug them...I called them every 2-3 days and no one ever called me to tell me I was approved. I got the call from the surgeon's office who said they received the approval. Aetna was supposed to call me with an approval but they didn't. I was told they are supposed to mail it.

I have Aetna and I was approved on yesterday for the gastric sleeve. It's very important that you do not gain weight during the 3 month or 6 month program. I did the 3 month process and had to have one psyc visit, 3 visits with my NUT, 4 visits with my surgeon, a sleep study, chest x-ray, EKG and PFT (Pulmonary Function Test). I don't know if Aetna requires all these exams but it was on the checklist that my surgeon's office gave me. Call Aetna and have them email or mail you the requirements for your plan because every plan is different. Good luck!

You can try looking for other insurance that does cover it...it's about that time for open enrollment so I would consider that. If not, going to Mexico is another option.

NSV for sure!!! I cannot wait until I have that same view when my husband goes "downtown"

I read that a period after weight loss surgery is normal, however I would say call your doctor to be sure. It could be your body adjusting to the shock from having surgery but it won't hurt to get checked out.

@@Elode @@thisfathasgot2go thank you so much! I am so happy!

I just received approved today from Aetna and it took a week. Weird because I called Aetna yesterday and they told me a decision was still pending. I called them every 2-3 days.

Got a call this morning from the insurance coordinator stating that Aetna approved me for the gastric sleeve!!! Woot Woot!!! It's crazy because I called Aetna yesterday and was told that a decision was still pending. The approval process took a week. Feeling pretty blessed.

I haven't had VSG yet but I did do some research regarding the gallbladder. What I read is that most surgeons prescribe a medication called actigall which helps prevent gallbladder stones/issues after VSG. It seems that a lot of people end up needing the gallbladder removed after VSG. I am going to ask my surgeon the next time I see him if he will prescribe me something to prevent gallbladder attacks/gallstones after surgery. Good luck to you!

I have been bugging my insurance company every 2-3 days for an update on whether I've been approved or not....don't feel bad about calling them. keep calling until you get a response.

same here...I keep calling my insurance every 2-3 days asking for status on whether I have been approved or not. The surgeon's office said they will call me with an update but I just can't wait lol. Be optimistic and hope for the best

It depends on your insurance... Aetna says not to gain weight but people have been approved even with weight gain. I need a letter of medical necessity from my pcp too but before the pcp will write the letter I have to come in for blood work. Best of luck to you and call Cigna or go online to see if weight gain is an issue. Don't give up!

Walk walk and walk...also drink peppermint tea

I'm not in CA but I've never heard of anyone needing a pap or a mammogram for weight loss surgery... did Medi-Cal tell you that? I needed a chest xray, EKG, pulmonary function test, psych exam and 3 months of dietician /nutritionist visits and 4 visits with my surgeon... good luck!

Yes a lot of people have been nervous prior to surgery. Just know that you will be in great hands surrounded by medical professionals whose best interest is do perform a successful surgery for you. Best wishes to you!

every insurance is different, therefore the requirements will be different. I work in insurance and I only dealt with Medi-Cal a handful of times. I would suggest calling medi-cal and ask what the requirements are. That way, when it's time to submit everything to medi-cal, you'll be covered. Good luck!

I wish surgeons would stop doing the liquid pre-op. my surgeon doesn't require it. He said 2 weeks before the surgery I'll be put on a low carb-high Protein diet. And it produces the same results that a liquid diet would. I don't think severe diarrhea is normal. Try calling the surgeon to see what he/she suggests. Make sure you drink as much Fluid as possible since you are losing electrolytes because of the diarrhea.

I would say talk to your surgeon and explain the dilemma to him. I told my surgeon that I wanted to take no longer than a week off from work and he agreed I could go back to work in less than a week because I also have a sit down job. Talk nice but firm and let him know that you have to work in order to pay your bills. Also, see if your employer allows "PTO donation". At my previous job, we were able to give our PTO to a fellow employee up to 4 increments at a time. How much time are you looking to be away from work?

good luck! I am waiting for an approval too