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Hi everyone.

I've only made on other post and that was my welcome post. I have Carefirst BCBS and live in MD/DC area, my starting BMI was 40.5 & I have sleep apnea. I got a call from the ins coordinator the day she was submitting to BCBS for approval that it's policy for folks getting the sleeve to have 50+ BMI. I was floored, but I told her to submit any way and asked if they would help me fight the battle. She assured me the office believed in lower BMI folks getting sleeved.

Initially it was denied, and they decided on a peer-to-peer review...well guess what? I was approved!

I was so ready to battle...collecting information -- and ready to write a thesis!

I've scheduled for 10/1 so that we can get our kids in their school routine and have my dad come and help my husband out with the kids while I'm recovering.

Still in shock!

O yeah -- we're going on a cruise 21 days post-op...One week to Bermuda -- I'm a travel agent and fall travel is so reasonable!

Thanks for reading and posting such great stories! I've learned alot from you all.

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Congrats on your approval! I also needed a peer-to-peer review before I got approved by BCBS.

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We're so blessed! I just need to find the patience to last until 10/1.

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Congratulations!

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Do you really have to have a BMI of 50? My MBI was 39.7. I have lots of co-morbidities: high bp, wacky cholesterol, stage 3, kidney disease, sleep apnea and gerd. I want the sleeve not bypass.

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Do you really have to have a BMI of 50? My MBI was 39.7. I have lots of co-morbidities: high bp, wacky cholesterol, stage 3, kidney disease, sleep apnea and gerd. I want the sleeve not bypass.

KZBen, all insurances are different, even different flavors of the same insurance company (e.g., BCBS IL is different from BCBS MD). My BCBS had BMI requirements of 40 without comorbidities and 35 with at least two.

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Kat's right...the policy for my Carefirst BCBS in DC/MD is 50, but I made sure to use a surgeon who's affiliated with a Bariatric Center for Excellence and the team in that office is wonderful. My ins coordinator fought for me...I'm sending them an edible arrangements once I'm post-op...they were great.

Again I was ready to put up my dukes...It just make sense to allow lower BMI patients the opportunity for the sleeve.

Also, don't forget your employer can opt to not cover any bariatric procedure. So many factors!

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Congrats!!! How exciting :). I'm so nervous my insurance will play games with me after reading all these stories

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Thanks!!

Just arm yourself with knowledge and be prepared to fight, should they initially deny.

Congrats!!! How exciting :). I'm so nervous my insurance will play games with me after reading all these stories

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Like what? I want to be prepared but not sure with what. I think it's a huge joke they made me do these past 6 months. A waste of everyone's time and money. Gah! Wish I could just send in and see. My last appt Aug 13

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I didn't have too much resistance...so hopefully you can read some of the other posts...some folks had to seriously jump through hoops to get approval.

Like what? I want to be prepared but not sure with what. I think it's a huge joke they made me do these past 6 months. A waste of everyone's time and money. Gah! Wish I could just send in and see. My last appt Aug 13

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I thought my last appt was last month.

I have to get a bunch of labs, gall bladder ultrasound, EKG, Chest x-ray, bloodwork, pcp approval for surgery, 2 hours class at the hospital, and a pre-op visit with my surgeon! I think there's more and I've forgot

I didn't have too much resistance...so hopefully you can read some of the other posts...some folks had to seriously jump through hoops to get approval.

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Congrats!! Last hurdle till the big day!!! I'm happy for you!

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My insurance said 6 months of consecutive weight loss program. Lord knows I have done everything- many times but nothing documented for 6 months in a row. The program I'm in has requirements of its own such as NUT appts- psychological- labs- meet with a personal trainer for three sessions. I hope thats enough ;)

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Thank you...I'm a bag of nerves.

The thought of not having all this weight excites me! But I'm nervous about maintaining my weight...I dropped some weight since I started with my surgeon in Jan and they said if I can maintain it until surgery day I won't have to do the liquid diet...so hoping I don't have too...

Congrats!! Last hurdle till the big day!!! I'm happy for you!

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    • 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.
      · 0 replies
      1. This update has no replies.
    • 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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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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      https://alluniqueguide.com/java-burn-coffee-reviews/
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