Futr littl Debi

Kristin - I am so impressed. Surgery today and you are already online to give to support to those of us who are following you in. I'm ready to go in the morning. I hope it goes as well for me.

Thanks for all the wishes everyone! I can't believe it...just 11 more hours :biggrin2:

Hi Cutie - I'm on August 6th too and I'm getting really excited! I see that you are also in Orange County, CA. I am in Fountain Valley and getting banded at Orange Coast Memorial. Where are you going?

Thanks Lanakila! I found them online and ordered some. It looks like a pretty good supplement to help get all that protein in!

Hi everybody - my name is Debi. I am 47 years old and live in Orange County, California. I have 2 grown boys - 25 and 22. My youngest still lives with me while going to college. I am a lawyer, working in the compliance area of a large health insurance company. I didn't care for practicing law, so this is a good fit for me. It also leaves me sitting behind a desk all day, so I have just grown and grown over the years. Like most of you, I have dieted many times. I am great at losing weight. I am not great at keeping it off. That's why I am so excited about this surgery. I love the idea that as you lose weight, you can get a fill so that it keeps working. And later, during the maintenance of your weight loss, you can still actively monitor your fill level so that everything stays good. What a GREAT concept! I am scheduled for surgery 1 week from tomorrow and couldn't be more excited:thumbup:

Lanakila - what is a bullet? I have only heard the individual size blenders called that, but it sounds like you are talking about a jello type thing instead.

Well, I have tried and tried. I can't get Nina's version to animate. I think it is really cool, but no luck for me. I'm saving it as a gif, any idea what I am doing wrong?

I have PacifiCare HMO and they are covering Lapband. PacifiCare doesn't have an exclusion for it, but the coverage that your employer purchased might. I would call customer service and find out for sure. Their number is on your ID card. The last time I checked, the only weight loss surgeries that PacifiCare covers (if the employer purchases weight loss surgery coverage) is gastric bypass and Lapband. Perhaps the person you talked to got confused thinking it was a different procedure. Anyway, check your policy and call customer service at PacifiCare instead of your IPA (the group that your doctor belongs too). It is the IPA's job to administer the PacifiCare coverage. They have to follow the PacifiCare rules on it. Good luck.

Usually, if you have coverage under 2 policies, there is a coordination of benefits clause. You need to read that section of your secondary policy. The typical coordination of benefits says that if the insurance is secondary, they will pay up to the amount they would have paid if they were primary. In the case where the primary insurance doesn't cover a specific procedure, the secondary insurance would cover it up to their regular policy limits. If this is the case with your policy, you would need to get a letter of denial from your primary insurance to submit to the secondary insurance as proof of what the primary insurance paid - $0. Remember - all insurance is different and what is in the policy will tell you what your coverage is in this circumstance. After you read the coordination of benefits section, call customer service at your secondary insurance to see what your next steps are. Good luck!

My favorite so far is the August All-Stars!

Congrats Shelby! I'm August 6th too, so we'll be in this together.

Hi Serenity, I'm sorry that Fountain Valley is quite a ways away for you. I live in Fountain Valley and my doctor's group sent me to Dr. Leport's office. That's probably the group PacifiCare is trying to send you to as well. That whole office has been wonderful. I really like them. So take heart, even if you don't win the argument with PacifiCare about not driving so far, at least they say it will be covered. And they do bunch up the pre-op appointments for you, so you won't have to drive down here constantly. Just think, some people have to fly to different states or countries to get this done. We can count ourselves among the lucky ones.:thumbup:

Hi - I'm on August 6th too. I'm in Fountain Valley, California.

Awesome Augusts?

I have the PacifiCare HMO plan. When I started this (April 2007), I needed to get a referral from my PCP for a bariatric surgeon consult. PacifiCare responded with a denial of the authorization and instead referred me to their Healthy Roads program. This was a 6 month telephone support program. After 5 months of that, PacifiCare changed their requirement and no longer required the Healthy Roads program. So I went back to my PCP and she submitted another request for the referral for the bariatric surgeon consult. This time, it was approved. I went to the consult and they told me that in order to submit for approval for PacifiCare, I needed the nutrician appointment and the psychiatric consult. The surgeon's office made those appointments for me and once I completed those, we submitted for approval. I was approved in about a week. Overall, not a bad experience. I just needed to pay the office visit copay for the surgeon's visit and the psych visit. I will also have to pay the copay for the hospital. Good luck to you!

Joanna, I went for my one on one at the beginning of May with Dr. Leport. He's a really nice guy. Anyway, he told me that he wanted me to take off between 10 and 20 pounds prior to surgery, but he didn't care what diet I wanted to follow to do that. He recommended the Optifast because it is effective, but the choice was mine. I decided to try to do it on my own. A little more than 1 week prior to surgery, I had lost 7 pounds - not quite enough. So I called and got a week's worth of the Optifast. That did the trick. And it wasn't too bad either. I really liked the strawberry flavor. My teeth were still hungry, but at least it kept my stomach happy. Of course, now that I had to reschedule, I have put on half of what I lost. So now I get to do it again.

Hi Joanna! I'm being banded on August 6th by Dr. Leport. I was supposed to be banded on June 2nd (after waiting on the schedule for 4 months), but at the last minute, by PCP decided she wanted me to see an endocrinologist for my high thyroid before she would sign the medical clearance. Talk about disappointment! But Dr. Leport's staff was great with the rescheduling. I just got signed off by everyone late last week and they are getting me in August 6th. That's not nearly as bad as it could have been.

Hi - About the Centers of Excellence requirement...that is a designation that the doctor / hospital program gets from an outside entity. It isn't an extra class provided by the insurance company. My insurance company has that requirement too.

Hi everybody. I too am from Southern California. I am a lawyer working in the compliance department of a major health insurance company. I am 47 years old and am looking forward to being healthier. I was scheduled for surgery on June 2nd after 4 months on the waiting list. They canceled surgery at the last minute due to a bad pre op test result on my thyroid. We should be able to get it under control soon and get me rescheduled. But boy - I was really looking forward to getting on to the next phase of my life.

I too was scheduled for June 2nd, but at the last minute, the doctors decided that my thyroid levels were too high. I now have to see an endocrinologist and get signed off there. The surgeon swears that I won't have to wait another 2-3 months to get back on his schedule. Jeez...it took 4 months to get on his schedule the first time. I then found out that I can't get in to see the specialist until June 19th, so I figured what the heck. I went to Vegas. I am soooo bummed.

I'm on the 2nd too! I can't wait. Let me know how everything goes.

I have told a couple of people at work, my kids and my sister. I wasn't planning to discuss it with my mother because she can't keep anything private. Unfortunately, she overheard me ordering Optifast over the phone for my last week. So I told her about it. Of course, she immediately told all of her friends. It's not that I am shy about the surgery - I just don't want to be the topic of their conversation. And now they are saying they will be watching me to see how I do so they can pass the word. I'm not wild about being watched.

Martucci - be careful about choosing the doctor. Because you have a Medicare Advantage plan, you have to use one of the doctor's that is contracted with your plan. Also, if the Medicare Advantage plan is an HMO, you will need to get a referral from your primary care physician to see the bariatric surgeon. It is true that the Medicare Advantage plan will follow the Medicare guidelines, but that just means that they will cover everything that Original Medicare covers. Call the customer service phone number on your Medicare Advantage card to find out what you need to do to get the surgery covered under your plan. Good Luck!

I'll be in Fountain Valley, CA. Good luck in Colorado!

Hi everybody... I know it's a ways off, but my date is June 2nd. Anybody else for June yet?