Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Trying Not To Get My Hopes Up Re: Insurance



Recommended Posts

Hello, everyone! I am a 39 (almost 40) year old wife and mom of two awesome boys. I decided a few months ago that lap band surgery was the way to go. I have lost and gained and lost and gained for the last 10 years and I'm over it. I have Carefirst BlueCrossBlueShield and I feel like I've met all of the requirements, but I am afraid to get my hopes up. I go back and forth between a BMI of 39 and 40...of course the 40 is required. I plan to have a big lunch on Thursday before I meet with with the surgeon. ;) I feel like my future is in the hands of someone who doesn't even know me. It is such and uncomfortable feeling.

Share this post


Link to post
Share on other sites

Hello, everyone! I am a 39 (almost 40) year old wife and mom of two awesome boys. I decided a few months ago that lap band surgery was the way to go. I have lost and gained and lost and gained for the last 10 years and I'm over it. I have Carefirst BlueCrossBlueShield and I feel like I've met all of the requirements, but I am afraid to get my hopes up. I go back and forth between a BMI of 39 and 40...of course the 40 is required. I plan to have a big lunch on Thursday before I meet with with the surgeon. ;) I feel like my future is in the hands of someone who doesn't even know me. It is such and uncomfortable feeling.

I completley understand and was right there where you are a week ago before I found out I got approved. Keep the faith and think possitive! It will happen for you :)

Share this post


Link to post
Share on other sites

I completley understand and was right there where you are a week ago before I found out I got approved. Keep the faith and think possitive! It will happen for you :)

I forgot to tell you. I actually wore ankle weights in the begining to get me over that 40 BMI hump. Insurance requirements can be a challenge. Keep us posted!!

Share this post


Link to post
Share on other sites

Thanks, Roxygirl! How long did it take to get your approval?

Share this post


Link to post
Share on other sites

Good luck.

Share this post


Link to post
Share on other sites

Thank you, Suzi! Roxygirl...what a great idea!

Share this post


Link to post
Share on other sites

Suzi--I am going to the same practice! I noticed your surgeon's name...I'm seeing Dr. Averbach on Thursday. Were you happy with the practice?

Share this post


Link to post
Share on other sites

Thanks, Roxygirl! How long did it take to get your approval?

Well I first started out last December 2011 and then found out in February of this year that my insurance required a 6 month weight management. My last day for that was August 1st and my paper work was submitted to insurance on Friday, August 3rd and I found out Friday. So 7 days of complete misery waiting to be approved. Do you have any co morbidities?? I have 2 and a mils 3rd so I think that helped.

Share this post


Link to post
Share on other sites

I meant mild ;)

Share this post


Link to post
Share on other sites

No co-morbidities...never thought I'd be bummed about saying that! lol! The 6 month diet is a concern for me. I've done weight watchers for 6 months and have receipts and before that I did 8 months of Medifast with Health Coach and I have documentation. I am hoping they will accept all of this so I don't have to wait for another 6 month diet. I've been dieting for over a year and have lost and gained more pounds than I care to remember. I'm going to be a wreck waiting to hear for the decision. 7 day, huh? I hope that they just tell me...like ripping off a band aid!

Share this post


Link to post
Share on other sites

They took my weight watchers info fine. Yes I line the practice. Are you going to mapke lawn or the other office. Tina- manger/ insurance preop nurse- is really helpful. Have seen both doctors for fills. Both nice. Surgery was at St Agnes hospital. - Great staff and super supportive nurses. Everyone on floor was for WLS. First went in office in August 2011 had surgery 12/19/11. Started at weight watchers in June 2011. Lost 65 pounds so far. Bmi was 43 I think. Now 32. Good luck.

Share this post


Link to post
Share on other sites

So glad to hear that the WW was accepted. That's a huge relief! I am seeing Dr. Averbach in Catsonville on Thursday, but I'm hoping to go to Maple Lawn for follow up appointments. The Catsonville office had the first "new patient" appointment available. I'd rather drive a bit than wait any longer! I'm glad to hear that you felt comfortable with the practice! Thanks for the "review"!! :)

Share this post


Link to post
Share on other sites

No co-morbidities...never thought I'd be bummed about saying that! lol! The 6 month diet is a concern for me. I've done weight watchers for 6 months and have receipts and before that I did 8 months of Medifast with Health Coach and I have documentation. I am hoping they will accept all of this so I don't have to wait for another 6 month diet. I've been dieting for over a year and have lost and gained more pounds than I care to remember. I'm going to be a wreck waiting to hear for the decision. 7 day, huh? I hope that they just tell me...like ripping off a band aid!

My insurance required 2 years of weight history and diet attempts and then the 6 month requirement was through my bariatric DR and a nutritionist. Can you call your insurance and ask or do you have a member handbook to refer to??

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 1 reply
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×