FinallyLosingIt20

I have discovered that I really like the Fairlife Nutrition Plan Protein Shake. This is the 30g Protein shake that is not in the refrigerator section of the grocery store. - it is with the other protein drinks on the shelf at Sam's Club. It tastes like chocolate milk. I am lactose intolerant, but I can drink these. There are 4 carbs in one shake,

Hi Everyone! I'm from NW Indiana, and I started my journey nearly 18 months ago! After pills, diets, exercise, etc. I finally got a referral from my family doctor to see a bariatric surgeon last July. I called my insurance company and they said my insurance was covered if I met their prerequisites. I let the surgeon know and they of course called after my first appointment and they got the list of prerequisites. Although I had spent 6 months on a supervised diet with weigh ins twice a month, I had to do 6 months with the doctor and nutritionist, maintain my weight, have a 5 year history, show previous attempts to lose weight, etc. So I did all the standard things, and it was time to submit to insurance in February of 2020. I got a call from the nurse at UHC to check on me after my procedure, but I had not yet had any procedure. Nothing was approved yet! So the nurse checked and the procedure was denied - it was excluded by my policy! I was upset and appealed. My surgeon appealed, because they had a preapproval number from September. Still, UHC refused to cover anything. I was upset, and researched it. I found a website for my state that had information about Healthcare complaints, so I filed a complaint and included information about their calls with me and the doctor's office. I suggested that they review the calls and retrain their employees to properly look at a caller's insurance, because they always say to "Call the number on the back of your card to verify benefits." Then COVID 19 closes everything. The doctor's office closed my case, and I started researching self-pay. I found Blossom Bariatrics in Las Vegas, and I paid my deposit and scheduled surgery for June. Yesterday I received a letter from UHC. They are paying for my surgery with my original surgeon. I thought it was an error, a joke, a dream?!?! I called my surgeon's office and sent them a copy of the letter. They called me in shock and asked what I am doing in July. Well, I think I'm having my Gastric Bypass and hernia repair in July now - close to home and without traveling. I'm worried something will happen to change that. I am out $550 because I paid a deposit to Blossom and for an appointment. I called today to reschedule for now - I don't want to cancel and have my other surgery fall through and be left with nothing. My surgeon's office said I am only the second person to successfully battle UHC over their error and actually win. I am worried the bill will exceed the $40,000 limit that was not a condition of the original guidelines, and I am scared they will find a reason to refuse payment. I am anxiously awaiting surgery in 6 weeks and 4 days.

I was wondering if anyone can share any information about their insurance having a maximum benefit for WLS and if they had additional out of pocket costs because of it. My insurance - United Healthcare (UHC) - has told me they will pay no more than $40,000 for me to have surgery with my original surgeon who is in network at a center of excellence. The surgeon's office pointed it out to me yesterday, and I asked if that was enough, and she said as long as I don't have complications I should be okay. I'm worried because I am having a hiatal hernia repair and rny. My last hernia repair was $44,000 but the hospital allowed insurance to pay $7,000. Won't that same principal apply here?

Thanks! I am planning on joining their group. It looks like it will be very helpful! I am doing a wine run! LOL! Seriously, you register, do a virtual 5k, post your results, and get your swag bag including a new wine glass! I always say better wine than Whine! I am really trying to stay calm.

I know I'm letting my anxiety play too big of a part in this, and I find myself catastrophizing... so my next question is this: Has anyone ever gone to Blossom or to another surgical center and been sent home without their surgery because they failed the stress test or something else? I'm worried because I have a bundle branch block (BBB) - I told them and they have a cardiac clearance from my cardiologist - but they still perform the stress test and EGD, etc prior to surgery there. I exercise regularly, but the BBB can make it appear that things are not right. The BBB is ironically because I am overweight. I'm really anxious, because this is my last chance. My doctor here will not finance and insurance excludes it. I do not smoke and I will follow my 2 week diet when it starts in 2 weeks. Thanks for all input.

I'm having hiatal hernia surgery too! 😀 No one I know needs to know any more than that!

I'm going to have to do this. I love the support, input, and ideas that I find when I go to those groups, but knowing that a coworker could find me there causes anxiety.

Thank you for all the information. I greatly appreciate it! I’m worried about the compression socks being hot.

That’s a great idea!

I think I am! Blossom - surgery on Monday and a flight home on Wednesday.

For those of you who traveled for your surgery, I would love to know how bad the flight home is? I’m having surgery June 22nd in Vegas and flying home two days later. It’s about a 4 hour flight. I’m nervous about flying so soon, but I have no choice. I appreciate the info! TIA.

I'm flying in on the 17th 😀

I just got mine scheduled for June 22nd! Flying in the week before.

Mobroke, I had my insurance - UHC - also say it was excluded after initially telling me and the doctor’s office that it was covered! I am waiting for Blossom to schedule my surgery now. My doctor’s office was excited for me, so I feel more confident about this.

You would think so, but unfortunately it started with new management. Our new owner is a personal trainer on the side. Since they purchased the company when her grandpa - our founder - died suddenly last year, the culture has changed immensely. I am very unhappy there. I've been on this journey for over a year now, and I was so happy to find this site. I'm scared of someone finding me if I post on Facebook.