Ok so I am gearing up to have the Sleeve Gastrectomy and wanted a way to catalogue my experience. My start weight is 221 and my goal weight is 135. I have my first appointment on March 12, 2012 to find out if I will be accepted into the program that my insurance covers. Because I live in a rural area I have to go over 300 miles from home to meet my surgical team. I will take a photo journal to document the metamorphosis that will be taking place.

Well, congrats and you go girl! I'm impressed that you are dedicated enough to travel that far for surgery. Just an FYI for you, sometimes you can deduct mileage for medical purposes, so keep track of your expenses and mileage for the tax man!

So I am trying to find anyone that has Anthem Blue Cross / CalPERS, Pers Select to help me wade through the insurance nightmare. They tell me that they won't have any answers until they hear from my surgeon. The surgeon does not have answers without the insurance and I'm in a loop....

I am waiting for my appointment and wanting to know what this will be like for me on the other side. I don't have support at home for my decision and was told I could exercise more, eat less ~ you all know the usual. It's hard when I don't over eat, my 6 year old eats more then I do, I don't have a metabolism due to my former life style. I found out the results from my sleep study (co-morbidity factor) is mild and not the moderate/severe I was hoping for. I have less then 7 days to gain 8 pounds to qualify for weight purposes only. So discouraged at this point.

Missy, I am not that far ahead of you in the program. I just finished jumping through all the hoops with the various tests and now I'm waiting for the results of the last few tests to make it to the surgeon's office. My wife and I have Anthem BC/BS that began in California, but since we now live in Arizona, it has transferred to here. She is retired from CA State service with 30 years, and, without her medical insurance, I would not have a chance at getting this surgery, so I'm grateful for that. I was told by my surgeon's insurance girl that Anthem BC/BS is one of the easiest companies to get clearance from, so I'm very hopeful that I'll get approval and a surgery date soon. Hope this gives you some confidence that all will go well. I've only been on this road for a month and patience is not my strong suit, but I've decided I'm going to do whatever I have to do to get the surgery. Stay in touch......John

Well I spoke to my surgeons office yesterday and they are able to use some of my documented weights from my doctors office to get me qualified. I hit 227 in January and they can use that so it should get me into the program with insurance approval. When I told my partner that I may not qualify he told me that the money we have saved for my portion of the medical expense can just be used to buy exercise equipment. Man that was not what I wanted to hear! I wish I could explain the feelings I have because of my weight....

Missy' date=' I am not that far ahead of you in the program. I just finished jumping through all the hoops with the various tests and now I'm waiting for the results of the last few tests to make it to the surgeon's office. My wife and I have Anthem BC/BS that began in California, but since we now live in Arizona, it has transferred to here. She is retired from CA State service with 30 years, and, without her medical insurance, I would not have a chance at getting this surgery, so I'm grateful for that. I was told by my surgeon's insurance girl that Anthem BC/BS is one of the easiest companies to get clearance from, so I'm very hopeful that I'll get approval and a surgery date soon. Hope this gives you some confidence that all will go well. I've only been on this road for a month and patience is not my strong suit, but I've decided I'm going to do whatever I have to do to get the surgery. Stay in touch......John[/quote']

I have Anthem BCBS PPO Plus and was only required to have 1 Psych visit and 1 Dietician visit. Doctor was paid 100% and hospital 90% - I ended up out of pocket approx $1500 (in Texas) and hospital was willing to setup payment plan if needed. I started process on January 17th and had surgery on March 5th.

Hope that helps and your Anthem coverage is similiar.

Thank you Liberated. Hoping that I will be qualified. Going in today to do a pre surgical appointment weigh in to get the BMI Anthem requires. Thought that my apnea would be enough, not severe enough for them. Got plans to make this happen. CROSS YOUR FINGERS FOR ME PEEPS!!!

SO I had to cancel my appointment for Monday. I had a high weight of 221 and am 62.5 inches tall this makes my BMI 39.8 and the .2 that I don't have could get me disqualified. I had a bout of diverticulitis last week and lost 8 lbs from the liquid diet.

I am re grouping and could use some encouragement to get through this. I feel like this will never happen for me and am very discouraged.

I have Anthem BCBS PPO Plus and was only required to have 1 Psych visit and 1 Dietician visit. Doctor was paid 100% and hospital 90% - I ended up out of pocket approx 1500 (in Texas) and hospital was willing to setup payment plan if needed. I started process on January 17th and had surgery on March 5th.

Hope that helps and your Anthem coverage is similiar. <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/smile.png' class='bbc_emoticon' alt='' />

I am from Texas also. Same thing 1 psych 1 dietician and will pay 900 total. But I have been on this since Aug 11, my pcp had to monitor me for 6 mths. My insurance does not allow you to gain weight are you will be denied. My surgery is scheduled for April 2. This is starting to feel real now

I am from Texas also. Same thing 1 psych 1 dietician and will pay 900 total. But I have been on this since Aug 11, my pcp had to monitor me for 6 mths. My insurance does not allow you to gain weight are you will be denied. My surgery is scheduled for April 2. This is starting to feel real now

I have not had anything submitted to my insurance yet which is why I cancelled my pre surgical consult, if I went and was "under" or gain after I would be disqualified. Would take 18-24 months to have them re-evaluate me. Cancelling now before anything goes to insurance allows me the opportunity to meet the 40 BMI requirement

Well I spoke to my surgeons office yesterday and they are able to use some of my documented weights from my doctors office to get me qualified. I hit 227 in January and they can use that so it should get me into the program with insurance approval. When I told my partner that I may not qualify he told me that the money we have saved for my portion of the medical expense can just be used to buy exercise equipment. Man that was not what I wanted to hear! I wish I could explain the feelings I have because of my weight....

I have not had anything submitted to my insurance yet which is why I cancelled my pre surgical consult' date=' if I went and was "under" or gain after I would be disqualified. Would take 18-24 months to have them re-evaluate me. Cancelling now before anything goes to insurance allows me the opportunity to meet the 40 BMI requirement[/quote']

Missy,

Hope all goes well and you get approved for the surgery. My insurance does not cover the surgery so I financed it through Carecredit. Please keep me posted on your progress. My surgery is 3/23/12.

Patty

Apparently the 227 I thought they documented in January was not in my chart and I am now "too small" for the insurance requirements. So discouraged.

Apparently the 227 I thought they documented in January was not in my chart and I am now "too small" for the insurance requirements. So discouraged. <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/sad.png' class='bbc_emoticon' alt='' />

I am so sorry you are having problems. Good luck to you!!!!!

OK so this morning the surgeon submitted to insurance. I have a tentative surgery date of 6/7/2012. I am now at 205 with a high weight of 224. I have done all the pre surgical requirements and they are asking for me to begin some vitamin supplements. Vit D, Calcium and a multi vitamin.