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Do you have insurance that approved the sleeve?

Hello,

Some of you may remember me. I was going to have the sleeve done on 4/15 but my lawyer (trustee) wanted me to try and lose the weight on my own instead of spending all that money out of pocket for the surgery.

Since then, I have been trying really hard to eat right and work out. Of course I haven't lost any weight. I've actually gained weight and can't understand it! (No I have not gained muscle b/c my clothes are tighter so I know its fat!)

Anyway... One big stresser was my job! I finally got a new job working for an insurance company so I have excellent benefits now and according to the benefits list, the insurance I picked will cover bariatric surgery 100%!

As soon as I get settled in to the new job, I'm going to start the adventure again and look into the surgery.

I was just wondering if any of you had the surgery in the states and had insurance that covered the sleeve? I know its rare but I really don't want to have any other bariatric surgery other then the sleeve. Its so stupid! I don't understand why its still considered experimental!

Thanks for letting me know!

Kara

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There is an HMO here in California called Western Health Advantage that covers the sleeve and my current HMO Kaiser Permanente that is covering my sleeve surgery 100%.

Cahnge for the better. You and I are about the same size! I have Cigna insurance and after the 6 months supervised diet and a trip to the nutritionist and the Psychiatrist, my insurace approved me for sleeve surgery. I wish you the best of luck. With most insurances it is either the higher BMI or high BMI with co-morbidity issues.

Hi - I have UHC and they approved the gastric sleeve. They didn't make me jump through hoops but they did require the following:

5 year history of obesity

6 month supervised diet (3 of which had to be consecutive)

At least 100 pds over goal weight or I think a 30 BMI and a co-morbidity.

Need Psychological Eval

I started the journey in May 2010 - and had all paperwork ready before Memorial Day weekend and was approved within 2 weeks.

However, my general physician was really good about putting the papers together. I have seen her for 15 years so she was wonderful about it.

I am scheduled to go in on June 29th -- every day I question my decision. I am on the Optifast diet and have been on it for 10 days and have lost 7 pounds. The first week I only lost 3 and I was stressed out because I thought to myself -- I am NOT eating and I only lose 3 pounds in one week what about when I do start eating? How am I going to lose anything? Does that make sense?

I am scared because I have two small children who need their mother HEALTHY!! But, like everyone, I am scared of not coming back to them. But I am trying to be optimistic and deal with the decision that I have made. :thumbup:

I think with any surgery we question our decision!!! But I think we also over stress outselves and sometimes overthing things. I am sure you will be just fine and come through with flying colors and be a healthier Mother with a lot more energy to enjoy your children.

Keep us posted!!

Hi - I have UHC and they approved the gastric sleeve. They didn't make me jump through hoops but they did require the following:

5 year history of obesity

6 month supervised diet (3 of which had to be consecutive)

At least 100 pds over goal weight or I think a 30 BMI and a co-morbidity.

Need Psychological Eval

I started the journey in May 2010 - and had all paperwork ready before Memorial Day weekend and was approved within 2 weeks.

However, my general physician was really good about putting the papers together. I have seen her for 15 years so she was wonderful about it.

I am scheduled to go in on June 29th -- every day I question my decision. I am on the Optifast diet and have been on it for 10 days and have lost 7 pounds. The first week I only lost 3 and I was stressed out because I thought to myself -- I am NOT eating and I only lose 3 pounds in one week what about when I do start eating? How am I going to lose anything? Does that make sense?

I am scared because I have two small children who need their mother HEALTHY!! But, like everyone, I am scared of not coming back to them. But I am trying to be optimistic and deal with the decision that I have made. :thumbup:

I have UHC but my plan doesn't cover any obesity services. I appealed and am waiting to hear back. I know what you mean about 2 small kids. I have a 2 yr old and 5 yr old. I feel selfish for getting the surgery because there is a chance I could leave them motherless but I know I will continue to be over weight my entire life if I don't. No great words of wisdom, just that I'm in the same boat with you :)

I have UHC and I was required to do the 6 month weight loss program with my surgeon. The time really flies honestly. It is worth it. I have my last weigh in on July 1st. Hoping for a quick approval and surgery date soon.

I feel selfish for getting the surgery

I felt selfish, vain, etc. Then I questioned what I was doing getting an elective surgery. I wasn't 'that' obese... I was finished with the surgery and 4 days later I was texting my hubby on how stupid I was.

Now, 13 days post surgery, 14 # lost, I am very glad. I deserve a healthy life with my family and my family deserves a healthy mom. How many times do you put your needs on the back burner to take care of the kids/hubby. This will be about you! (and your hubby and kids will benefit for the new you).

Good luck.

Terrie

This surgery is one step on the journey to a healthier you. If you are commited to using the tool along with diet and exercise you can accomplish anything. I am amazed at the stories on this forum of people who have reached their goal (and are keeping it off)... and the people who are doing it right now!! I am so glad I found this forum. Before reading some of the responses in here I felt like I was sooo alone. It is nice to have people who really "GET" what you are experiencing.. pre-op and post.

I've had UHC since it first became UHC in Arizona. I tried on my own to get approved in years past for bypass, and was always turned down. I'm thankful for that. In January I went to my information seminar and learned of the sleeve. I had never heard of it before. The Doctors office did all the work this time. I spent the next 6 weeks doing all my appointments....sleep study, psych, blood work, nutritional counseling, pcp letter, etc. The liason for the Dr's. office sent the paper work in on Friday morning. On Monday morning she called to say I was approved.

I've been super morbidly obese (over 300 lbs) for the last 23 years. I had (notice I say now...HAD) high blood pressure and on 3 meds for it. Osteo arthritis and on Celebrex, gout, and prediabetic. Maybe this was why they gave me approval so quickly.

I ahve UHC Choice plus and they paid for mine 2 months ago. When you get ur card go to the my uhc website and look under ur benefits.There was a phone number for Bariatric resource services 1-800-936-7246 and they told me of my employers covered it. I was dead in the water until I called them as I had already gone to a seminar and couldnt get anything from insurance so after 3 weeks I called them and it was easy from then on. I had to have a 6 month diet history and a psych eval. If I can help in any way pm me.Carla:biggrin0:

I have Blue Cross/Blue Shield through my husbands work. I had no problem getting approved. They told me my BMI had to be 45 or over and mine was 52. They cover 100% of the hospital stay and 90% of the Doctor.

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WOW! So glad to hear all the positive news about how insurance is covering the sleeve now. I'm pretty positive that my UHC Choice Plus will cover it, I just don't know what pre op requirements I will have to meet. I guess all I can do is wait to get my insurance card and then start the process as soon as it comes in. I have been seeing the same doctor since I was 14 so I'm sure there is plenty of documentation of the 2 times I was on Phentermine, the several years of my yo yo weight. The constant talk about what I can do about my weight....

If I have to do a 6 mo pre op diet that wouldn't be a problem either. I just want to try and have the surgery before the end of January. I have it all planned out. I can recover for 1 1/2 years and then get pregnant and have my first child before I'm 28!

You see, I have it all planned out! :) I just hope everything finally falls into place!!!

Thanks for all the information!

Kara

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