creed2474

Yeah, I plan on it!!! I just don't want to be working two jobs for the rest of my life!!!!

yeah I found out my premium is really high because I am part-time...but, it is worth it. I'm going with a doctors office who knows the insurance very well. It is a 3 hour drive but I feel very safe to know that they know what they are doing. I will have double coverage...but my primary insurance does not cover anything related to weight loss surgery. So, my secondary which is bcbsfed hopefully will cover everything.... what I wonder is will my primary cover those two 100 dollar co-pays? And, if I ever lose my fed plan... will the primary (who says doesn't cover anything) kick in and pay for follow-ups and fills, etc. related to the surgery.

gumbo- you never let us know what happened.... did you talk to them about it?

What is it like? tell me what they do?.... does it hurt? what do they give you to kill the pain? Do they knock you out? How long does it take?

Yeah, that is why i'm pressing to have mine done ASAP. Hopefully December!!!!

Can you pm me and tell me what clinic you work for? I just want to be able to compare doctors. Yes, she asked my height, weight....and I told her I was diagnosed with sleep apnea and I have a cpap machine.... she then said...we consider you as a "slam dunk" patient. lol

You are right on the money! Thank you for clearing it up! You put all the pieces of the puzzle together for me. Thanks I heard that if it is done out-patient.... you are also responsible for some of the cost of the band itself. If it is done inpatient you are not. I asked the lady today about that...and she said their clinic requires it to be inpatient so not to worry. She said I would get the approval in like 3 days once it is submitted. Does that sound right Kathy? I guess my clinic is going to do the psych and nutritionist as their requirement...which is not a big deal. She said I can do all that when I have my first appointment with the surgeon.

Me personally...from the 4 offices I have talked to. I don't think it is required..... I think the office is either a) more used to doing regular bcbs and gets it confused... the office is looking at it as .... what if the insurance comes back and says that it is required? Who pays for the procedure then? They are trying to cover their butts. The insurance doesn't give pre-auth like regular insurances..... that is why they are trying to cross all corners in case something is wrong and the insurance asks for more. I may be wrong... but, that is what I have gathered by calling several different offices and asking questions. I'm just that way... I do alot of research especially with something this major.... i read online and asked questions....compared...and called offices and asked questions..and compared. I want to see it in writing tho that it is not required. I have yet to find it..... I'll let u know what happens after I go to my first appointment Nov 14th. Where do you live?

Can you please point me to the direction where it says this online? I would like to have this in case this becomes an issue.

that is what I don't understand... where are they getting their information from? oh well...i'm sure everything will go well in a few weeks. I'll be seeing the doc prolly November 14th along with my psych eval and seeing a nutritionist. *crossing fingers*

ugh.. I get different stories with different dr offices. I had one tell me that although they don't require a "DR" supervised medical weight loss you have to show proof, (Jenny Craig, etc.) for at least six months. She said I could not turn in the medical records showing my history of me being over-weight and writing a statement on my weight loss attempts over the years. I again asked her are u sure... this is not regular blue cross..this is federal. she said she called blue cross and even looked in the book...and it says it is required. Then, I call another office... no diet history is required with federal insurance..... she said they will schedule an appointment... on that day I have my psych eval and meet with nutritionist. She said they request the medical records and see how long I have been over-weight. She said they get the paperwork together..and submit it to the insurance and it usually takes about 3 days to get an approval. I asked her...so, I don't have to do a diet for 6 months? she said no it is not required for federal blue cross blue shield insurance. she said realistically december is so busy for them that the surgery would probably be sometime in january if all went well. she basically said i'm a 'slam dunk' patient with my bmi and my sleep apnea. I hate getting different stories from different offices... the last one is the only one out of 3 offices that said it is not required. I think they are getting mixed up with regular blue cross and federal blue cross or something?

Which doctor did you use? What clinic? Did your primary do all the paperwork for you?

Man, i'm so excited! You just paid a 100 dollar co-pay for the doc and 100 dollar for the hospital? longhorn mom.. which doc and clinic did you go through? Did you have any problems with them and how did you like them? I just hope I don't run into a road block. I have been a federal employee in the past for a year starting nov 07..... paid blue cross blue shield out of my check every two weeks but i never even used the insurance. I left the job for health reasons. A year later I am about to start back.... I just hope me just working part-time doesn't get in the way of what it covers. I wouldn't think that it would? As soon as the insurance kicks in i'm going to the doctor..... do you think me working part-time on and off... will get in the way? Or, with me just starting the coverage in Nov and going to the doc to have the surgery in Nov?

I don't have any copies of my doctors visits..... i'm sure medical records will show my weight over the years? I hope it goes as easy as most people...... I do have sleep apnea and it is diagnosed and I have been on a CPAP machine for almost 5 years now. And, my BMI is over 40..... so, you would think I would have no problems.

are you a federal employee?

I'm just wondering... has anyone had to wait to complete a 6 month diet plan or whatever? With FEDERAL Blue Cross Blue Shield Basic or Standard? From the first time you saw the doctor... how long did it take you to have the surgery and what was the process?

Yeah, even if the other insurance doesn't cover the fills, etc. I think I can handle the out-of-pocket. Exactly tho on the part-time.... I did the part-time job for a year ... and left about a year ago..... I had to leave because I started feeling really fatigued and depressed. It was too much for my plate at the time.... I started having diabete type symptons...but, nothing was wrong. She just said I need to lose the 2nd job due to fatigue. I really didn't need the 2nd job anyway... I was just doing it for extra money to blow. lol I think with me getting the surgery... I will probably be able to handle it due to the increased energy. I'm in the perfect city for excercise.... Austin, Texas.... there are alot of highly motivated people here.... so, i'm sure it will rub off on me. I just need that extra little push (lap band) that will help me. I'm very excited..but at the same time I am scared. I will have the best insurance you can have.... so, I have a feeling it is going to be very quick and not alot of time to think about it. Which is probably better.... lol I have learned alot from this forum..... I appreciate everyone's responses.

Well, I start my job back Nov 3rd and my insurance coverage starts Nov 9th. I'm going with Federal BCBS..... my friend had it two years ago..... went to a great surgeon in Dallas.... told him he wanted to do the surgery..two weeks later. WOW But, he rescheduled to do it a month later. He and his wife did the gastric by pass at around the same time. He only paid for himself 200 dollars for co-pays and that was it. So, I'm looking to have the surgery ASAP. Bring it on!!!! Even if it means not having turkey this Thanksgiving! LOL

lol i'm sorry. I read what you said wrong.

My part-time insurance will cover the surgery. i was talking about if I ever left.... would my state insurance cover the fills, etc. later on down the road. Out of pocket is not too expensive I found out.....for fills, etc.

She told me the fills are only 50 dollars out of pocket..... I can handle that. She said it would be more if it is another type of appointment.... but, I think I can handle that part. What i'm worried about is if something goes bad..and I don't have my federal insurance.... and my state insurance doesn't pay..... what happens then? They leave you to die? lol

Thanks everyone... I made an appointment for a seminar with southwest bariatrics also.

I just registered for his seminar next week....

Yes, that is the Dr. I am talking about. Not Gantz like I originally posted.... all the people I have spoken with in that office seem really nice and have helped me. That is the one i want to go with. What hopsital did you go to?

Unfortunately the insurance group plans differ. So, I don't think we have that here in Texas. My state insurance is Blue Cross Blue Shield. And, my federal insurance to be will be Federal Blue Cross Blue Shield. The federal one will cover everything.....with the surgery... but the other insurance does not. It's a weird situation I know.