staceface

Aetna. It sucks because I realized I wasn't really that far below the weight I need to be for them to cover it, but I can't bring myself to gain and hold there just for the surgery. I'm slowly losing just by watching my carbs - from 230 down to 223 - but obviously I'm not gonna get the results on my own that people are getting with this amazing surgery... SIGH... My doctor actually said it might be worth trying to fight them and get a waiver because I might not have their SPECIFIC comorbidities they want to see, but I DO have other issues aggravated by obesity. I'll see her again soon. We'll see what she says.

Thanks everyone. I think that's the route I have to go. As nice as it would be to "just self pay"...I'm a divorced mom of 3 and that kind of money doesn't come easily. I guess I play the insurance game and know that it will all be worth it!! Sent from my iPhone using the BariatricPal App

If I could self pay I totally would. Might look into it. Because even if I gain those 7 lbs or so, they're gonna want HISTORY of BMI > 40 won't they? I'm at my heaviest right now (38) and it's plenty heavy believe me!! So maybe self pay is the way to go Sent from my iPhone using the BariatricPal App

I think that's what happened with my girlfriend who is always dieting with me; I think she had the immediate fear that I will be skinny and she will still be struggling and no one wants to be "the fat one"... Sent from my iPhone using the BariatricPal App

(Curious to hear responses on this as well...) Sent from my iPhone using the BariatricPal App

Thank you guys. Yeah; I have high cholesterol but according to Aetna that's not one of the specific comorbidities that allows bariatric surgery <40 BMI. My doctor is all for it; at my last visit when she rattled off the details at the end into her little recorder she listed everything she could think of that would benefit from weight loss - I have high cholesterol, I've been seeing a podiatrist because my feet hurt so bad from standing and walking so much with 230lbs to carry around, I need to have back surgery but I can't imagine trying to recover at this weight... She'll be all for it if I tell her damn, guess I have to gain a few to lose a lot. Sent from my iPhone using the BariatricPal App

Aetna high deductible plan. And I was so eager because I'd met my deductible for the year, but even if I go this route, end up at 40 BMI, then it won't be til next year anyway so I'll have to start over with my deductible. Still better than $13,100 tho. Sent from my iPhone using the BariatricPal App

No you're absolutely right. If I had weighed in last week I surely WOULD have met weight; we all know how it is when you struggle with your weight; we fluctuate so much. Ok, I'm not giving up. Sent from my iPhone using the BariatricPal App

Wow, I'm excited for you. When my dr first told me to "go for it" she said not to let anyone try to talk me into the band. I hope the sleeve doesn't come with the same issues for you! Sent from my iPhone using the BariatricPal App

Ok, then I'm gonna quit my pity party tho it probably put me at the required weight :-/ I'll get in touch with the bariatric place tomorrow and ask if I can do another "consult" in a week or so. Betcha I could blow that 7 lbs out of the Water (no, I'm not proud of that...) Thanks everyone. I needed this support. Sent from my iPhone using the BariatricPal App

So my dr asked how long I'd have to keep it on; I said I had no idea. Anyone know? I mean, if I have a consult and I meet the criteria then slowly lose before surgery, am I out? Sent from my iPhone using the BariatricPal App

I even sent my PCP a text to say wait! I only have to gain like 7 lbs! She even kind of agrees. Sent from my iPhone using the BariatricPal App

No, you're all right... why didn't I do the math to begin with??? I weighed 229 today at the consult; I'd only have to weigh 236 to have a BMI of 40. That's one day! Ugh! Sent from my iPhone using the BariatricPal App

So my insurance wants me either heavier (BMI 40) or to have very SPECIFIC comorbidities (which I don't have). My BMI is 38.8 but I don't have diabetes or heart disease. My best bet is to pay cash - $13,100. Yeah, I don't just have that kind of cash available. I'm so disappointed. I started to really wrap my mind around the changes you have to make beforehand, the changes afterward, and now I feel so let down. Stupid insurance. Don't they realize I'm gonna cost them more in the long run if I stay this big or get bigger!!!? Anyway... I wish everyone else the absolute best. Maybe I'll continue to watch everyone so I can send positive thoughts your way. Sent from my iPhone using the BariatricPal App

Ok; I get it. Friends who have always been on the weight loss roller coaster with you, tried every fad diet, every new exercise routine, and had moderate success with you at times... they don't really like you taking this new step, do they? Sigh...I guess that means someone you've always counted on to be a cheerleader will instead be judgmental and say stupid things about this being the "easy" way even though there isn't anything easy about it!! I guess you can't make everyone happy... Sent from my iPhone using the BariatricPal App