Melisa1

Hi guys...i dont know if im in the right place to ask this question but...I have UHC ppo. They cover 90% for bariatric surgery. Ive done all my testing. sleep study, ekg, blood, urin, chest xray and endoscopy. Then "today" my surgeons office tells me that i have to have a five year history of having a bmi over 40 or two co morbidities. First of all...why didnt they tell me this at the beginning? and second is this stated in my policy? they flat out told me all of a sudden that it wont be approved by my insurance? This is such a slap in the face. Ive been over weight all my life, my bmi is 40 and i weigh 230 lbs. 5'3". Yes my weight has dropped 5-10 lbs up and down forever but COME ON. thats rediculous! Does anyone have any recommendations or ideas, answers, hope??

Hi guys...i dont know if im in the right place to ask this question but...I have UHC ppo. They cover 90% for bariatric surgery. Ive done all my testing. sleep study, ekg, blood, urin, chest xray and endoscopy. Then "today" my surgeons office tells me that i have to have a five year history of having a bmi over 40 or two co morbidities. First of all...why didnt they tell me this at the beginning? and second is this stated in my policy? they flat out told me all of a sudden that it wont be approved by my insurance? This is such a slap in the face. Ive been over weight all my life, my bmi is 40 and i weigh 230 lbs. 5'3". Yes my weight has dropped 5-10 lbs up and down forever but COME ON. thats rediculous! Does anyone have any recommendations or ideas, answers, hope??:rolleyes2:

Yeah you can bring as much as you want but i guess it depends on how far you have to drive home. I was close so i threw my clothes on and drove home to shower and get ready for my day. depends on what you are doing and how far away you are.

psticern....do you know when the new band comes out? ive been thinking about that and thinking..."great...im gonna get a band and then they are going to come out with a new one" ? would you wait if you were me?

I just had my sleep study done. all i needed was my jammies. Since you are going early in the eveining, bring your favorite magazines, maybe a light snack and a bottle of water. Thats all you really need. I got up in the morning, threw on my clothes and was outta there!! Good luck!

YESSS....she is right....GO!!!

Im in santa barbara area and my psy eval was cake. I paid $150 cash and he was simple. 30 min and we were done. Ive heard many horror stories about different tests and expensive evaluations that these psy dr.s do that take hours and they all want their money up front. if you want the # of the guy who did mine im sure he wouldnt mind doing yours if you drove down here. let me know.

If this has been going on for very long you need to go to the hospital. Especially if you cannot get ahold of your dr. You dont want to get dehidrated!! They will find someone who knows how to take some of the fill out. after that you should be just fine. this is common when you are first trying to figure out how much fill is right for you. good luck, stay calm and go to the hospital if it doesnt improve soon!

My best friend is getting ready to have it done soon. She asked the surgeon and he said yes...he would recommend it and do it.

ok ..thank you id love to talk to you...

Long2Bfree...omg...im sooo excited to find you!!! I live in santa maria and im getting banded by Dr. Thoman as well. Id LOVE to talk to you. Im doing my pre op diet right now...trying to loose that 5% uugg...but doing ok. Waiting for the dr to send me what other tests he wants done. That should come any day now.:smile2:

from what ive heard over and over with UHC they like to see a bmi of 40 or more but if you have co morbiditys...i would appeal for sure and have your doc write a letter to them. Good luck.:smile2:

I have UHC too. What you need to do is call them and ask them if they cover for bariatric surgery. Ask them if there are any restrictions or exclusions on your policy. They should be able to read it straitght up to you and tell you if you have coverage. Every policy is different. Looks like mine covers. Good luck!!:cursing:

We can have liquids for the first two weeks. I plan on buying different kinds of broth, crystal light,sugar free popcicles, all kinds of sugar free jello and any other tasty liquids...i know it sounds boring...im scared of that too...i havent been banded yet either but...from what ive heard we wont be that hungry anyways and just a little will fill us up. Once we get through that first two weeks we can go on soft foods such as apple sauce, cottage cheese, egg drop soup, and anything pureed. It will be ok.

Good question...im glad you are switching to UHC....ive heard horror stories about kaiser. You should be able to just get your history and submitt it to UHC. Im sure this happens all the time.

ok thank you very much!!

Hey restlessmonkey....are there good lapband books out there to read or magazines we can read?? Id love to be reading all about it and sucess stories too while im waiting for my surgery.:thumbup:

Yeah i would call and ask...i hated the waiting game...and im still waiting on stuff...but i wait a while then i dont hesitate to just pick up the phone and ask just for my own expectation and piece of mind. Good luck to you! :thumbup:

wow im soo excited to hear that. I had my psy appointment today and it went soo well. Only 30 min and done! Now im just trying to loose the 12 lbs b4 surgery....its hard...darnit...but im trying. Im also waiting for the letter in the mail from the surgeon telling me what further tests he wants. Everything is going smooth and steady...im happy and excited but it seems like its still going slow lol. Hey what protein shake did you end up buying...? i dont even know where to start. Also what vitamins did you end up getting?

:thumbup:That is wonderful!!! Im soo happy for you! I cant wait to have mine! Im kinda getting nervous because everything seems to be going sooo smooth and the ball is rolling faster that i thought..very scary for me. I see the psy for my evaluation this monday. Im trying to loose my 5% right now which is hard. Ive lost 2 lbs ...only 10 to go lol. Was the liquid diet the first two weeks hard? ANd how is the food thing going right now?:mad2:

Thank you so much! Today is my appointment with the dietition and i cant wait!! Ive been trying to maintain or even gain a little weight before this appointment because my bmi is right at 40. However i just got diagnosed with gerd. (gastro esopphigal reflux disease) so i think that works as a co morbidity. I will keep my fingers crossed. Isnt that sad. lol anyways im sure everthing will be fine..i just get all nervouse that something will go wrong where i cant have it for some stupid reason. But i dont think that will happen. I also need to make my psy appointment today. I hope they can get me in soon. Then all i will have i think is bloodwork, ekg and maybe an ultrasound of my gallbladder? we shall see. good luck w everything!!

Hi Melissa my name is Melisa too only its spelled Melisa. Im in the process of seeing the nutritionist and taking care of appointments at this time. Im hoping to have my surgery within a month. Im keeping my fingers crossed that insurance doesnt hold me up at all!! Good luck with your journey as well.:thumbup:

That is AWESOME poohprecious!!!! Glad to hear that! And Amarie677 how did yours go? and how are you doing? Im just very curious because im hopefully having mine within a month!!!!

Just wanted to see how your surgeries went? I hope everything went well and you are doing great...please let us know.

I would just review your dr records for the past 5 years or go speak your concerns to your pcp so he can take a look at the history. Between your pcp and your gyno you should be able to find out your bmi throughtout thos years. If you have an co morbidities like diabetes, high blood pressure, sleep apnea and such those will look good in the pre determination letter from your doctor to your insurance. Dont give up and work hard and you will suceed!!! good luck!