samiott

I just heard from St. Mary's and they said that UHC is going over their 2010 benefits and I should hear something by next week.

:smile2: Hi.... Can anyone recommend somehting to help me firm up saggy skin besides having plastic surgery.... I have lost 102 pounds so far (6 more to go) and I work out 5 days a week, 3 days doing cardio and 2 days circuit training. Has anyone had success with any particular exercise program to firm up that loose shar pei type skin?

Thanks!

I read an article once that said that losing muscle helps to cause the loose skin and lots of exercise, drinking Water, and TIME will help to bring the skin back. It said the skin needed time to recover just like any other organ. It may mean that some people's skin just takes more time to heal than others. It also mentioned that there was still fat deposits left inside the skin and that's why more exercise is needed.

I don't remember where I read it but I remembered that part of it. I think the link was once posted here on the forum.

Thanks for all the replies. It gives me some ideas how to manage my life around the surgery :smile2:

I was told not to lift more than 10-15 lbs for 6 weeks.

But I start grad classes in a couple of weeks so I dunno what's gonna go on with that...

My surgery was at 8 a.m. and I was home by 2 p.m.

My lift restrictions were 5 pounds the first week, 10 pounds by the end of the 2nd week. Then 'normal lifting' ok...until he found out that normal lifting for me was 50-75#. Then he revised it to no more than 15-20 pounds *max* for 4 weeks after surgery.

Ok thank you for your quick responses :biggrin:. I guess maybe I will have to split my books into separate bags and make more than one trip to my car or have a friend help me carry them for a couple weeks.

I at first posted this in the pre-banded area...

If I get approved for surgery then it will be at St. Marys and Elizabeth hospital.

How late in the day was your surgery? Anyone who was the last one of the day?

Also, I'm in college and have some very HEAVY books. I will have a roller bag but I live on the second floor with only a flight of stairs to get up and down. How soon were you able to lift heavy things like a heavy book bag (also in and out of the car)?

Thanks,

Sandy

If I get approved for surgery then it will be at St. Marys and Elizabeth hospital.

How late in the day was your surgery? Anyone who was the last one of the day?

Also, I'm in college and have some very HEAVY books. I will have a roller bag but I live on the second floor with only a flight of stairs to get up and down. How soon were you able to lift heavy things like a heavy book bag (also in and out of the car)?

Thanks,

Sandy

Samiott - the band will change your life for the better. It certainly has mine. It's too bad your husband isn't super supportive but you know yourself and if you need help or not. I think often people who have never struggled with weight just don't understand how hard it can be especially when you need to lose so much and such an impossible task it seems. How far in the process are you, have you seen the doctor yet? I love my doctor with the St. Mary's group, very caring and informative. Once you have surgery scheduled they have you go through a pre op day at the hospital for lots of testing then later that next week they have you meet with your doctor a day before surgery and that is when you pay (if you have to). When the call to schedule your surgery they also tell you exactly when you will have to pay anything if applicable.

I just called St Mary's and they said that UHC is now "IN NETWORK"!!!!!!

So I won't have to pay the $4k up front and I don't have to bother my husband with it! :thumbup:

Samiott - the band will change your life for the better. It certainly has mine. It's too bad your husband isn't super supportive but you know yourself and if you need help or not. I think often people who have never struggled with weight just don't understand how hard it can be especially when you need to lose so much and such an impossible task it seems. How far in the process are you, have you seen the doctor yet? I love my doctor with the St. Mary's group, very caring and informative. Once you have surgery scheduled they have you go through a pre op day at the hospital for lots of testing then later that next week they have you meet with your doctor a day before surgery and that is when you pay (if you have to). When the call to schedule your surgery they also tell you exactly when you will have to pay anything if applicable.

Right now, I just sent my packet into St. Mary's. I haven't seen the Dr yet. I went to the seminar a couple months ago and have been waiting for "In Network" status. I called them the other day and they said they were "In Network" on Dec. 1st. Now I just need to find out what this means payment wise. I have been going to a nutritionist since Sept or Oct but I'm not sure if UHC will require it yet.

You are correct in saying the reason for the 4k charge that they charge you up front so they get the full $4k and not the insurance contractible rate which will be much less. How are fill charges in the Norton program? It's been a year since my surgery so I don't remember everything from the Norton meeting vs. St. Mary but I thought you had to pay for fills later with Norton where your fills are covered with St. Mary as long as they are your alloted fills. I haven't had to pay a dime to the doctor since I paid the $3,900 (and my insurance didn't pay me the full $3,900 back). The people who really get screwed are those without insurance since they don't get the insurance contract rate for the hospital either and have to pay a bunch for fills.

I'm just hoping there is little out of pocket expense. My husband is paying for my surgery and it was tough getting him to agree to let me get it done.

He's seen me struggle with my weight but he is naturally slim and a regular jogger so it's hard for him to understand my weight struggle. He's one of those guys that thinks he has all the answers to my problems. So the less I have to bother him about the surgery the better.

Has anyone had their surgery @ St. Marys and Elizabeth hospital after Dec. 1st, 2009? I called the other day and they said they are now considered "in network" with UHC. I'm not sure if I am understanding this right. I wonder if since they are "in network" if you would have to pay the $4000 up front before the surgery? I'm going to call them on Monday again to ask.

I did have to pay the $3,900 on the visit the days before my surgery. My insurance then sent me a check for the portion they covered. My insurance was not one of their "approved" plans so they made me pay up front.

Hmmm...so if the insurance is "in network" now (UHC just became "in network" on Dec. 1, 2009 at St. Marys and Elizabeth)... then maybe now I won't have to pay upfront?... I guess I will have to call and ask them on Monday...

I am going through St. Mary's program as well. I thought you had to pay the $4k upfront on your second visit with the doctor. I have already paid the $100 and I believe I have to pay the $4,000 next visit and then get my insurance to pay me. I may be wrong here but that is what I thought.

Did they require you to pay the $4000 upfront or did they send it to the insurance first?

They paid everything after except my $1,000 max out-of-pocket. The one thing to watch for is out of network providers I had one and it took awhile to get that paid they paid part of it and that provider took that as full payment but I almost had to pay $2,000 for that one.

When I went to the seminar a couple months ago the surgeon group was considered out of network but they weretrying to get put as in network thru UHC. I called the surgeon group the other day and they said they were now "in network" as of Dec. 1st.

Call your insurance company and ask if WLS is covered then ask them for the exact wording of the requirements. I have choice plus as well. If it's like mine, I can help you by telling you what I did...

I called them but they said they can't tell me anything until my Dr sends in my paperwork. I'm sticking it in the mail to my Dr tomorrow morning. They said at first that it was not covered but then I asked about medical necessity and then they said my Dr had to send in a letter for the medical necessity which shouldn't be a problem. I have HBP, Cholesterol, BMI of 40 and I'm on Diabetic meds.

My Dr needs to look over my paperwork and let me know if he will do my surgery, then he sends my information off to UHC.

btw, I have UHC Choice plus also, did you have any problems getting it approved?

Thanks! I do have Choice Plus.

Does UHC pay the bulk of the bills for a LAP-BAND®? How much could I expect to pay out of pocket? I'm sorry I'm new on my search for knowledge and I just want to make sure I take all the correct steps. :tongue: