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HI MY BENEFITS START 8/1/12, I WILL BE COVERED BY BCBS ANTHEM THROUGH MY EMPLOYER...IT HAS A $2000 ANNUAL DEDUCTIBLE AT 80/20 AND A TOTAL OUT OF POCKET DEDUCTIBLE OF $4000 AT 100%....I HAVE ALREADY WENT TO A SEMINAR..I SCHEDULED MY PRIMARY DOC VISIT FOR 8/2/12 IN THE A.M. AND MY INITIAL BARIATRIC CONSULTATION FOR 8/2/12 IN THE P.M...AT THE SEMINAR I SPOKE WITH THE FINANCIAL LIAISON THAT WORKS FOR THE DOCTORS OFFICE....AND SHE WAS EXCITED ABOUT MY INSURANCE PROVIDER...SHE WAS EXTREMELY CONFIDENT IN REASSURING ME THAT AS LONG AS I MEET THE REQUIREMENTS FOR THE SURGERY(IM 33 YEARS OLD/5'8/480 LBS/BMI 72.98/SLEEP APNEA) THINGS WILL GO SMOOTHLY AND QUICKLY...I ALREADY KNOW THAT AFTER MY ANNUAL DEDUCTIBLE OF $2000 IS MET THAT THERE IS A MONETARY OUT OF POCKET PAYMENT THAT I WILL HAVE TO MAKE....AND THATS WHAT IM INQUIRING ABOUT TODAY....IS OR HAS ANYONE HAD THE Roux En Y PROCEEDURE DONE AND BEEN COVERED UNDER THIS INSURANCE...IF SO I WOULD LIKE TO KNOW HOW THE APPROVAL PROCESS WENT...IF NOT TOO MUCH INFO, THE TOTAL AOUT OF POCKET PAYMENT THAT HAD TO BE MADE PRIOR TO GETTING THE SURGERY!!!! I WOULD GREATLY APPRECIATE ANY INFORMATION I CAN GET SO I CAN START PREPARING FOR A SMOOTH STRESS FREE PROCESS!!!! THANK YOU!!!

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Hi - I have Horizon BCBS / PPO plan and did not have any problems what so ever getting approval. My BMI was 36 which was under the 40 required but I also had high B/P which allowed me to have the surgery. The only out of pocket expense was a $250.00 co/payment for the 3 day hospital stay.

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I have anthem bc/bs and I was approved in less than two weeks. As a matter of fact I had my surgery after just one month of my first doctors appt.

The surgical center I went to had me fill out a lot of stuff online and I was fortunate enough to be able to take my psych evaluation over the phone as the psychologist said I didn't "raise any red flags". All of this happened before I actually stepped foot into their office.

I had to cram a lot of appts into a short period of time, sometimes two or three a day but that was really convenient for me and my work schedule.

My BMI was 40.1 and I didn't really have any complications due to my weight except for arthritis.

my total out of pocket was about 3000. But that was my fault for picking the least expensive coverage option at open enrollment last October.

Totally time was about 6 weeks after my first inquiry online. It all happened so fast sometimes I wake up in the morning and have to feel myself to make sure it wasn't all a dream.

I hope everything goes smoothly for you as well.

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HI MY BENEFITS START 8/1/12' date=' I WILL BE COVERED BY BCBS ANTHEM THROUGH MY EMPLOYER...IT HAS A 2000 ANNUAL DEDUCTIBLE AT 80/20 AND A TOTAL OUT OF POCKET DEDUCTIBLE OF 4000 AT 100%....I HAVE ALREADY WENT TO A SEMINAR..I SCHEDULED MY PRIMARY DOC VISIT FOR 8/2/12 IN THE A.M. AND MY INITIAL BARIATRIC CONSULTATION FOR 8/2/12 IN THE P.M...AT THE SEMINAR I SPOKE WITH THE FINANCIAL LIAISON THAT WORKS FOR THE DOCTORS OFFICE....AND SHE WAS EXCITED ABOUT MY INSURANCE PROVIDER...SHE WAS EXTREMELY CONFIDENT IN REASSURING ME THAT AS LONG AS I MEET THE REQUIREMENTS FOR THE SURGERY(IM 33 YEARS OLD/5'8/480 LBS/BMI 72.98/SLEEP APNEA) THINGS WILL GO SMOOTHLY AND QUICKLY...I ALREADY KNOW THAT AFTER MY ANNUAL DEDUCTIBLE OF 2000 IS MET THAT THERE IS A MONETARY OUT OF POCKET PAYMENT THAT I WILL HAVE TO MAKE....AND THATS WHAT IM INQUIRING ABOUT TODAY....IS OR HAS ANYONE HAD THE Roux En Y PROCEEDURE DONE AND BEEN COVERED UNDER THIS INSURANCE...IF SO I WOULD LIKE TO KNOW HOW THE APPROVAL PROCESS WENT...IF NOT TOO MUCH INFO, THE TOTAL AOUT OF POCKET PAYMENT THAT HAD TO BE MADE PRIOR TO GETTING THE SURGERY!!!! I WOULD GREATLY APPRECIATE ANY INFORMATION I CAN GET SO I CAN START PREPARING FOR A SMOOTH STRESS FREE PROCESS!!!! THANK YOU!!![/quote']

I have BCBS of TN FEDERAL EMPLOYEE PLAN. I've only paid a $300 copay so far.

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    • 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!
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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.
      · 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
      1. This update has no replies.
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