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On 10/23/2022 at 12:51 PM, ClarkRomulus said:

Hello all, I was wondering if any fellow Michiganders that have any tips on the best insurance for weight loss surgery. My employer has open enrollment and I’m thinking about switching insurances to a plan that has a shorter wait time for approval. My current plan is a year. Thanks

Would probably be best to ask this as a new question rather than on an existing thread for fed insurance. Also be advised surgical programs have their own waiting lists and COVID may strike again so switching a plan that already has coverage to get surgery sooner may not be worth your time. My three month long wait from my insurance ended up being 17 months.

I can start more solid foods tomorrow. So excited! I’m so sick of Soup and liquidy foods! First thing I’m getting is a bowl of Wendy’s chili.

8 minutes ago, Snetsky said:

I’ve been told that I’m likely to be sent home with heparin syringes that I’ll need to self inject. I am TERRIFIED of needles and weirdly this is the thing that is freaking me out the most right now. Has anyone else had to do this? How long do you have to do this for? I asked the nurses during the pre op blood test session and they said they didn’t know.

Yeah, I got 28 days of blood thinner doses to inject post-op. Came at a surprise to me. The actual medicine burns more than the needle because the needle just penetrates fat, which we all have enough of here lol. A lot of people have some bruising from this though.

Have to go to the ER 😕

Had my surgery Thursday. Not gonna lie it’s been rough, please tell me it gets better 😭 I think it’s just gas pain but swallowing Water is hard, the pills are just torture. Only spent a night in the hospital and back home now.

11 minutes ago, raspberrylime said:

I kept calling my surgeons office last week for updates and they continued to give me the same excuse that my case is still "pending"... BUT after calling Blue Cross on Friday they explained that my surgeons office had to resubmit my case because they didn't add the codes for surgery the first time!!!! This made me so upset because no one at the office bothered to inform me of that. I reached back out to the office and the coordinator said she is requesting BCBS mark my case as urgent now. We're down to the wire (surgery is in 8 days!) And I could use all the well wishes and fingers crossed that I get approved on time 😔

Hoping it goes well! If they submitted it then you should hear back within 72 hours if it’s classified as urgent.

I went to my final pre-op appointment yesterday. Was nervous about being delayed bc the weight was up a few pounds but I was approved at all stops (surgeon, labs, anesthesiologist) to move forward! I’ll be the first case of the day on my surgery date too which is nice, the only procedure that’ll be done on time that day as they said lol. Been on my liquid diet for a few days and I’ve been doing all right with it, hope to get in every last bit of weight loss I can.

Starting my preop diet. Gotta be honest, one day in and I’m dying already!

Mine took nearly two months (no kidding) to submit to insurance after my final appointment. Took insurance a calendar week to approve it. Then it took 4-5 months to schedule my surgery for 2-3 months later. It’s been so long I’m ready to get this over with lol

I can sort of relate, though it has less to do with my insurance and more with the surgeon’s office/hospital. So busy. Called in March 2021, finally got in May 2021, and just now getting the surgery this coming October 2022 after all the required appointments and many delays. I was hoping to get it last fall so it’s been a year and a half in the making. Very curious as to how this holiday season will go because it’ll certainly be different…

Thank you all for your help, I’ve gotten a lot of helpful tips. My mom is coming around to me having surgery and has made it a normal part of our interactions. She will still return to work almost immediately after I have it done but it’s become less of a weird subject between us thankfully.

On 8/11/2022 at 2:39 PM, BAA624 said:

I had a full Tummy Tuck in July 2020 which was covered in part by insurance, as others have mentioned. Typically, the panniculectomy is covered when it's pre-certified, and then the excess fees to convert to abdominoplasty are paid out of pocket. At my very first consultation with my plastic surgeon, the first words out of his mouth were 'If I do just a panniculectomy, you are not going to be happy with the results. I very rarely anymore just do a panniculectomy.' He explained the difference to me: the panniculectomy is the removal of the apron of the hanging belly, or the pannus. The abdominoplasty goes a few steps further and tightens the loosened abdominal wall, and also includes liposuction. It also improves the appearance of the upper abdominal area and the belly button, as well as helping with posture and abdominal strength by tightening the abdominal muscles. However, in the insurance world, they are concerned with the functonality part of the skin removal, and the conversion to the full Tummy Tuck is beyond what is considered 'medically necessary.'

I am pleased with my tummy tuck and my surgeon is very talented. He works closely with bariatric patients, and I felt comfortable with what he was telling me and knew that he knew what he was doing.

Would you mind sharing your part of the cost? Am considering going this route when I get to that point.

If it weren’t for covid I’d probably have already had it. I just figure I’ve been like this for my whole life, another month won’t kill me.

It depends on the hospital. Both times I’ve had surgery with my insurance (non-WLS) I was billed for my portion after the fact. It’s usually copays I pay up front bc it’s a small charge but larger charges come later. If you’ve gotten preapproved already then the hospital shouldn’t be too paranoid…

Getting surgery in October. I’ve got some work events coming and my closet is pathetic right now. Would like to refresh it a little bit but I’ve got surgery coming up. I know the weight will take time to fall off but I’m in that weird area so not sure what to do. When did you stop buying clothes?

Bonus: if you’ve had the surgery, when did you need to start buying new clothes?

I have BCBS Fed and I didn’t have any specific evidence of previous medically supervised weight loss interventions so I freaked out about that, but I managed to get approved. I did go over my history with my dietitian and there’s some indication of weight loss in previous claims so maybe that’s what counted.

October 21. Been over a year in the making and the time is finally almost here (due to both the pandemic and me struggling to change my behaviors that led me here)

Finally got my surgery date! Will be 10/21. I’m sure my mom will find time to be with me immediately after surgery but come Monday I’m on my own. My surgeon’s office has informed me I may need to be out 4-6 weeks and that they want FMLA papers, which is more time than expected as I was planning to take a week off, I’m only a desk jockey.

My mom has missed a lot of work and doesn’t want to miss more, she’s been dealing with her own health issues and her company’s BS. She’s also less than enthused I’m going this route which is why she isn’t fighting harder to be with me I think.

What tips do you have for post-op recovery alone? My mom wants a home health nurse to come check on me but I’ll have to see if the surgeon will be willing to write an Rx for it, or will that be necessary?

I have BCBS Basic as an employee and was just approved! Was submitted last Monday and got a call about two hours ago so it took a week. Exciting!

ETA: I got a call from the insurance coordinator at the hospital, haven’t actually heard from BCBS yet.

I’m going to my last pre-op appointment (I believe) not this Tuesday but next to meet the surgeon and decided which surgery I’m getting. I also see UNMC is postponing surgeries as of 12/7/21 and am getting increasingly worried that it’ll affect me…

I hate waiting for him to finish his report. I know it’s the holidays but it’s been like 2 weeks. I’m so anxious to meet the surgeon finally and get this moving since my weight loss is beginning to stall and I don’t want to get back to my starting weight or risk having my surgery postponed if COVID gets uglier.

Excellent! I passed my psych eval and will visit the surgeon soon. Now pushing out my deadline… with any luck I’ll get my surgery by March of next year.

I might disagree with some of the comments here. You will maintain a relationship with your surgeon for awhile so it’s important to choose someone that will acknowledge you. I suppose with some programs the surgeon does their job then it’s off to the PA or dietitian but in others you should be having regular appointments afterwards and then yearly.

My gallbladder was removed recently. The surgeon did his job but his bedside was awful. However gallbladder removal isn’t life-changing and I’ve had no use for him since. Bariatric surgery is different. I’m surprised you haven’t had a meeting yet to at least discuss the best surgery for you.

5 minutes ago, happyhodges said:

Out of curiosity, I have 5 1/2 years in recovery in NA. I have my first appointment in Jan. Is there a possibility that I won't "pass" the psych eval due to history with addiction? I am also currently in OA! Just started working the program in OA and have 17 days abstinent. TIA!

If you’ve been sober (at least for the past year) then I don’t think you should have a problem at all. As for OA then I think the psych would expect you to overeat as many obese patients do. They’ll want to work on that though so maybe expect a few sessions with them depending on how thorough they are (some don’t care). The only things that disqualify someone is active substance abuse, suicidiality and an uncontrolled condition involving bad symptoms but even that’s temporary until you’re stable.

Update I finally passed my psych eval!

Cleared with psychologist as of last night… thank goodness