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Hi everyone,

I'm trying to find anyone that has this insurance that completed the required 3 months supervised diet and gained during that time. I was wondering if your surgeon's office submitted anyway and if you got approved. If it was denied, did you have to do another 3 months during the appeal?

I'm looking to revise from band to sleeve. When I started this I was 233 and 244 at my last weigh in on Mon apr 4. On wed the 6th I put myself on an all liquid diet and I'm down to between 235 and 236. I want to call the bariatric nurse tomorrow and ask her to schedule another weigh in for me and then submit

Do you think I should lose a lot more before I try?

Thanks for any suggestions/advice

Crystal

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I have BCBS-Fed and just completed my 3 month yesterday!!!! My BMI was right at 41 so I couldn't afford to lose any weight during the 3 months. I lost 2 lbs the first month and then gained 3 by the last month. It really depends on your BMI.... if you are way over 40 then I would recommend attempting to lose weight. If you are not, then DO NOT lose any weight!! Insurance will not approve you if you are not 40 BMI. I am currently waiting for the word from Dr's office on whether I'm approved or not. They submitted to insurance yesterday, so I should know before the end of the week. I'll keep you updated

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I have BCBS-Fed and just completed my 3 month yesterday!!!! My BMI was right at 41 so I couldn't afford to lose any weight during the 3 months. I lost 2 lbs the first month and then gained 3 by the last month. It really depends on your BMI.... if you are way over 40 then I would recommend attempting to lose weight. If you are not, then DO NOT lose any weight!! Insurance will not approve you if you are not 40 BMI. I am currently waiting for the word from Dr's office on whether I'm approved or not. They submitted to insurance yesterday, so I should know before the end of the week. I'll keep you updated

Thanks Stacy. Even if I got down to 229 my BMI will be 43.2 so I'm ok there. This morning I was 234. The nurse wants to show at least some loss from the initial weigh in. I'll be keeping my fingers crossed for both of us. And please do let me know what you find out from the ins co. Good luck!!!!!!!!!!!

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Ok so I have fepblue too. My first appt with pcp to start the 3 month diet was april 4th. does that mean that i have to wait all the way to july or can i be done in june????

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Ok so I have fepblue too. My first appt with pcp to start the 3 month diet was april 4th. does that mean that i have to wait all the way to july or can i be done in june????

You'll be done in June.

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It will be July, not June. April-May= month 1 May-June= month 2 and June-July= 3

I know because I thought mine would have been Jan-Mar but NO.... Jan thru April. It sucks but that's what they require.

BTW- I'm hoping today will be the day I get approval... They told me on Tues that it would be 24-48 hours and today = the 48 hours!! Please keep your fingers crossed for me!!!

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I was approved for surgery yesterday!!!! My date is 25 April... I'm so flippin excited!!!

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I was approved for surgery yesterday!!!! My date is 25 April... I'm so flippin excited!!!

That's awesome Stacy!!! You will be having surgery on my hubby's birthday!!! :)

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Sooo happy for you!!!! Good luck with everything. Here's to a smooth surgery, quick recovery and and complete success!!!

I was approved for surgery yesterday!!!! My date is 25 April... I'm so flippin excited!!!

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I have BCBS-Fed and just completed my 3 month yesterday!!!! My BMI was right at 41 so I couldn't afford to lose any weight during the 3 months. I lost 2 lbs the first month and then gained 3 by the last month. It really depends on your BMI.... if you are way over 40 then I would recommend attempting to lose weight. If you are not, then DO NOT lose any weight!! Insurance will not approve you if you are not 40 BMI. I am currently waiting for the word from Dr's office on whether I'm approved or not. They submitted to insurance yesterday, so I should know before the end of the week. I'll keep you updated

That's great news! I have Federal BCBS and my bariatric coordinator mistakenly submitted me for the bypass instead of the sleeve. I got approved for the bypass on Tuesday, but am now waiting to hear whether they'll approve me for the sleeve. No idea how they messed up like that, but the fact that you were approved for the sleeve gives me hope. We scheduled a date for 5/24, assuming that fepblue won't give me a problem about the sleeve and will approve me just as quickly. Good luck!

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So why is that some BCBS Fed will cover the Sleeve and some will not.

Lara

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Do you have FEP Blue? AKA Fed-BCBS? I dont think it really matters but on their website they list Bariatric Surgery. It doesnt specify which surgery they cover and which ones are excluded but I would call the number on the back of your card and see if they do! I think it's the BCBS of different states that dont cover the sleeve. I know for sure FEP Blue does cuz they approved me!

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I remember reading past posts on here that it's the state administrators of the federal bcbs plan that make the call. However, most of those posts were before December 2010. The 2011 plan brochure (p. 52) states that they cover the following:

Gastric restrictive procedures, gastric malabsorptive procedures, and combination restrictive and malabsorptive procedures

The sleeve is a gastric resstrictive procedure, which means that it is covered. If I recall, this language is different than the language in the 2010 plan brochure.

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I remember reading past posts on here that it's the state administrators of the federal bcbs plan that make the call. However, most of those posts were before December 2010. The 2011 plan brochure (p. 52) states that they cover the following:

Gastric restrictive procedures, gastric malabsorptive procedures, and combination restrictive and malabsorptive procedures

The sleeve is a gastric resstrictive procedure, which means that it is covered. If I recall, this language is different than the language in the 2010 plan brochure.

Well, this sounds promising. I will have to chewck it out. Thanks for the information!!

Lara

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      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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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