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Showing results for 'Fed BC/BS'.
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@@halalo - I have Anthem BC as well. Their rules changed as of January, 2015, now requiring the 6 months doctor-monitored weight loss program as a prerequisite. I was lucky in that I had coincidentally followed such a program in 2014, and they accepted it. My surgeon's office says that some Anthem case reviewers are sticklers for patients fulfilling this requirement; others are letting it slide. I had my surgery on 11/3/15.
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The written policy doesn't have a three month waiting period. It has a suggestion of a minimum of 3 nutritional visits, but everyone I've talked to at BSCA was very clear that there are no solid requirements. Look, they have really loosened up the policy. I was approved two months after my first NUT visit, less than three months after I attended the first information session. What they wanted was the medical info and clearances, and not a "really think about it" period. If anyone has told you differently -- well, I'm going to be honest, some of the folks at my care provider's were so used to the six month timeline that they repeatedly insisted that *surely* BS was not going to approve me quickly with only two NUT visits. However, the BS reps repeatedly told me to just have them submit the pre-auth -- and that if they were confused, they should talk to the BS reps directly. And you know what? It *was* approved immediately. And yes, my surgeon's office and NUT and other folks did not know the policy had changed, did not believe me, and kept looking for a secret checklist to follow. I had to print out and carry the written policy with me to reassure them. Advocate for yourself!
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Addendum to all that BS I wrote above...... I don't bother with my scales anymore anyway....... I go by how my clothes fit.
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BCBS Fed and 2 year weight history requirement
jane13 replied to MeFirst's topic in Insurance & Financing
@@MeFirst - where in Fl? I am in Jax. I also have BCBS fed~ -
I'm 9 weeks down 43 lbs.. To me it seems like a SLOW process or not even moving at times. My husband is in the oil field so you can imagine where this is going.. He hasn't worked in almost 3 months. I'm a stay at home mom to our 4 year old daughter. Times are rough now than its been in the past. I seem to be falling back into my old ways. I eat when I'm depressed, stressed, worried etc.. (Or I find myself going all day not eating Bc my mind is going 90 miles an hour). The things I chose to eat aren't always good either. I feel like I'm failing myself... But I have hit a road block! I look to food as support for what my husband and I are going thru. Let's not mention that not having a job already puts strain on your marriage. Just some advice would be helpful!! Or if u know of some WORK that would be great to! THANKS FOR LISTENING while I kinda vent. ????
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Protein Shakes - Do I have to?
Ilovecats1985 replied to Jackiesleeved2015's topic in POST-Operation Weight Loss Surgery Q&A
I had the exact same problem. I would seriously cry when I had to drink my protein Bc I made me feel bad and it tasted awful. I tried the nectar and life has been good since then. Those isopure clear drinks were disgusting and made my stomach hurt so bad. -
Everyone's said what I would say. Next time, pipe up. Correct the "friend" and tell the waitress your party needs a table because booth seating isn't comfortable. If your husband and this woman want to object over that, then they will be proving their true colors up front instead of this passive aggressive BS. I think many people (including me) feel self-conscious because of our weight and so don't want to draw attention to ourselves. I'd be beyond hurt and angry if my husband chose a friend's likes over my own comfort and enjoyment.
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4 years ago today, I was wheeled into surgery...
jintycb replied to Queen of Crop's topic in Tell Your Weight Loss Surgery Story
Hi queen of crop, took delivery of your book today and I'm having a great read. Not getting a lot done around the house but couldn't care less! As long as the dogs get walked and my nearest and dearest gets fed (plus a few other essentials) I am indulging my passion for being nosey about someone else's life. Yours. It is great to read about your journey and it is giving me an idea what to expect on mine although we have totally different lifestyles. I've got to just shy of four weeks post op and I am SICK of soup! I'm on protein shakes but have started making mine from scratch using pure whey powder, egg white protein, the artificial sweetener that I dislike least, dried skimmed milk, skimmed milk and natural flavouring. I shall be experimenting happily for some time to come. I intend moving onto mushy food in the next couple of days with soft scrambled egg topping my list. Can't wait. Oh, stepped on the scales yesterday and since my op on 21 Oct I have gone from 203lbs to190lbs. So, I'm going slowly but that's fine by me. It's a damn site more than I ever lost with Weight Watchers or whatever else I was trying during the last ten years. -
July 14 (or close )Sleeve Date Friends
ddlxray replied to AvalonNeeCee's topic in Gastric Sleeve Surgery Forums
I was sleeved July 2nd. SW was 256. Today I am 178. Down 78 lbs. Been bs cheating last 2 weeks. I really need to get back on track. So glad everyone is doing well. Congrats all! -
Must get back on track.....need a support/accountability buddy...sleeved 4/13
KR5 replied to kj44's topic in Gastric Sleeve Surgery Forums
I need help too bc eating too much all the time and gaining weight and it's been several yrs since I had gastric sleeve surgery and need so much help and support to get back on track from people who understand. -
Sleeved on 9th November
Munecagirl85 replied to Aria.p's topic in POST-Operation Weight Loss Surgery Q&A
Mine was the same date and ive had a time i did mine in Mexico and ive stuck well with liquids and go to the bathroom sooooo much!!!! I was in er for 15 hrs coming back bc i couldmt breath they lots of xrays and ct scans i was in the clear i also get a muscle spasam that comes and goes not bad bad pain tho Some naseau ive lost 10 lbs but iam so so miserable and down not so much bc of the food but the breathimg part i force myself,to walk and its slow but we need to Caffine weird ive not had that headace e yet beofr sugery i tried to diet and that was my first thing to happen -
Newlys sleeved (tuesdsy) i will try to make these my last two. ...i feel so out of breath¿
Munecagirl85 replied to Munecagirl85's topic in POST-Operation Weight Loss Surgery Q&A
Yeah i know and i just flew in a total of 10 airplanes for my surgery which was in mexico! I cant seem to wint for losing!!! Well this just means i have to stay extra extra extra healthy- no matter what bc ive had lots of ct scans my life time and dont plan on flying many planes in my future- ill have to stock up on extra antioxdkant Vitamins as well I guess eventually thismwill be easier but for. Now its crazy! -
Surgery is finally tomorrow! 11/10/15
rian_ replied to rian_'s topic in Gastric Sleeve Surgery Forums
It'll be here before you know! I think the anesthesia just did a number on me bc once that wore off I felt a 100x better. The pain post op will be there but that's expected. Most of my pain is on the right side but I've been trying to just take the pain medicine at night time so I don't become dependent on it. So far so good. I was 257 pre op and weighed myself this morning and I'm down to 249 already! -
Newlys sleeved (tuesdsy) i will try to make these my last two. ...i feel so out of breath¿
Munecagirl85 replied to Munecagirl85's topic in POST-Operation Weight Loss Surgery Q&A
Dang¡ i used it maybe twice! And bc they told me was for gas i figures id be fine and they never check ir asked if i used it i left it there -
Anyone having surgery in Oct ?
kvoneye replied to Jenaenae84's topic in PRE-Operation Weight Loss Surgery Q&A
Today is a bad day for me. I'm craving anything and everything which is making me crabby. I am wishing I never did this surgery. I ate supper too fast and am now paying for it. Holidays are coming and I can only think of what I can't have. I did by country time light bc I hate water now than ever before. Anyone else struggling like I am or have struggled? -
Newlys sleeved (tuesdsy) i will try to make these my last two. ...i feel so out of breath¿
Munecagirl85 replied to Munecagirl85's topic in POST-Operation Weight Loss Surgery Q&A
No i wasnt really given anything unless it was a blow thingy¿ i used it like once and they said that was for gas but i didnt have any gas - and i have done much of anything else iam not in pain really and just the breath thing I feel soo nauseated tho now maybe bc all the xrays and being scars to death! Uh now iam regretting my decison all that money and worry i just want to cry cry cry so bad ;( Sorry major venting. nOw -
Just thoughts....
Ilovecats1985 replied to Ilovecats1985's topic in POST-Operation Weight Loss Surgery Q&A
There is a couple in my group and they think it's their hour to talk about them only, their relationship, their kids, everything. They can get down right rude by interrupting people all the time. However they haven't been there the last two months. I have to say they have been the best two months Bc everyone gets a chance to share, ask questions, and so on. -
Current sleevers in Alabama?
Sparkle36703 replied to m.sexton's topic in Gastric Sleeve Surgery Forums
Hopefully Tuesday I will have some good news. I have to go in talk with my doctor again and see if he will do me a referral to Dr.Miles even though he is in my insurance network they said I would still have to get a referral from my primary dr yes I qualify for the surgery bc I am 5'8 and 400+ lbs with high blood pressure, diabetic and I think sleep apnea. So hopefully Monday he will approve it for me and I can start my process -
Federal BCBS approval when falling under 35 BMI
jane13 replied to NewLife1985's topic in Insurance & Financing
@@NewLife1985 - actually they did measure me and so did the NUT. My NUT was the one who told me I was just under 5'8" (shoeless). Measure yourself - it cant hurt. Point is, they may have you recorded at the wrong height I was over the BCBS fed BMI req plus I had two comorbidities. -
Federal BCBS approval when falling under 35 BMI
VDLT replied to NewLife1985's topic in Insurance & Financing
I had BCBS Fed Basic but my BMI was higher than that and I was also a revision from band. I wrote a two page letter explaining my issues and advocating for myself. You might want to try to do that. I would note that your weight has been climbing steadily and that you don't want to see that keep happening. According to your notes you met the 35 BMI requirement in October of 2014, correct? If they turn you down you can always try again in October. Since it is open season right now you might want to check into the other options available and see if one of them might have different guidelines and switch for the year. I love my Fed Basic though. There are several of us on here that have been approved by Fepblue, you might want to do a search and look at those threads. Good luck! -
Just had an appt with my Dr. and talked about revision. He let me know that the risk for leaks can be 15-20%. He said that could require tubing and being fed through and IV for weeks. (just explaining all complications per my request) I have two babies and couldn't even imagine having to deal with a leak! I am currently 232lbs. I have a couple options to consider.... 1. Take lapband out now and try to lose the weight with diet (which I have obviously failed at my whole life hence the lapband) NO revsion 2. Get down to 220lbs and have the lapband taken out and revision done in one operation 3. Have the lapband taken out now; try to lose weight on my own and if I fail, talk about having the revision done later. I was all for getting a revision, but now I am more nervous and scared about the whole process. I have a 1 and 2 year old and am not sure I want to risk my life and having complications to have a huge portion of my stomach removed.... I wish I could see into the future. Super anxious, nervous, and feeling defeated at the moment!
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Artificial sweeteners?
Ashlegal replied to jmlongVA's topic in POST-Operation Weight Loss Surgery Q&A
@@smb1966 As far as artificial sweeteners are concerned, all have their disadvantages and research suggests using them sparingly. I have been told by both my PCP and surgeon that our bodies can actually process zero-calorie sweeteners as it would sugar, causing both weight gain and insulin resistance. I try really hard to use any type of sweetener in extreme moderation. I used to use Splenda for recipes, especially for baking as it worked great as a substitute for white sugar, even the BS Splenda was a great alternative to regular brown sugar. However, I have recently discovered Monk Fruit (in the raw) and it has made a wonderful substitute for Splenda and or white sugar. It doesn't have that licorice taste that Stevia has and it is much sweeter than white sugar. http://www.intheraw.com/products/faqs/monk-fruit-in-the-raw -
Aching body after being released from hospital
queencity posted a topic in POST-Operation Weight Loss Surgery Q&A
I will be calling my surgeon this morning but i need to see if anyone else has experienced this. I had surgery Nov 9th and when i was released from hospital yesterday i felt great. But as soon as i got home i have this pain and ache all over my body. It feels like i just lifted weights for hours and like i have ran a marathon for the first time. I can barely walk bc of pain, although i am walking bc the surgeon said walking helps for everything but my body is asking me not to walk. Has anyone else had body aches ( i dont have any inner pain inside my body) ? If so what did you do and how long before it goes away? Please help. -
Update: talked to NUT she replied (we text) "The only one is at smoothie king is called a gladiator. Google cyntrax. They have lemonade and others. They have sample packages." I got a strawberry blueberry one this morning and I tolerated it well. I seem to be able to tolerate fruit flavors but not artificial or chocolate/vanilla flavored. Only problem was, I drink them fast enough and mine got whipped and became too texturized for me to handle. I may look into the Protein powder you can put into things. PS. today's victory? I can eat really soft noodles and that is so exciting bc everything is so nauseating lately.
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You know you lost weight when
sleevemom43013 replied to Thomas CPA's topic in Weight Loss Surgery Success Stories
When you borrow a car from your mom and feel small in it... and last time you drove it you couldn't wear the seat belt bc you were way too big for it
