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I know some insurances don't cover DS. What insurance do you have that worked and required less than six months weight management ? What was the BMI requirement?

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I know this thread is more for DS, but I wanted to chime in.

I have Cigna and have the band. For the weight loss surgeries (at the time I was only considering the sleeve or band but if I remember they didn't specify different requirements for different surgeries.

Anyways - the requirements for my Cigna was

*35 BMI with at least 1 comorbid condition - high cholesterol, sleep apnea, high blood pressure, etc

*40 BMI no other requirements

I was required to follow a 3 month physician supervised diet as well. No WW.

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I'm not sure if that's a Cigna generic policy or if that's just what my employer has negotiated in the 'package'. Do you currently have insurance or are you using this to shop around? Some people seem to be doing ok in NY on other posts with the new Affordable Care Act. I really do not know any details of that though.

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I am in the same boat; looking for the best insurance policy in NY with less weight management time in 2014 (because a lot of insurance policies changed their fine print). I'm interested in the LapBand. Any information would be appreciated.

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Oxford.

  1. 35 BMI with comorbidities;
  2. 40 BMI.

No supervised diet plan. This was in 2005, though. Don't know if it's changed since then.

Edited by Postop

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Apparently Oxford now requires a supervised diet plan for 2014.

I really don't want to wait 6 months; I know it's easy to make excuses about timing but 6 months doesn't work very well for me. This is the only time of year business is really slow (just finished the 2013 holiday season) and I need to take advantage now.

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I have BCBShield in NYC and got vsg done with all requirements in 3 months

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I got approved by Cigna for the DS.

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I have Blue Cross Blue Shield of IL (even though I live in Louisiana) they cover weight loss surgery but I'm not sure about DS specifically, but their requirements are:

BMI over 40 or BMI of 35 w/ 2 weight loss illnesses

Over 18yrs old

1 visit w/ nutritionist

1 psych eval

No supervised diets!

I had my consult, psych eval and nut visit all in February and now I'm just waiting on insurance approval for VSG.

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Turns out my insurance didn't require it, and they just go with whatever the doctor wants. Which is why I decided to switch to another surgeon, as I didn't see the need to do another six months (I had WLS two years ago.) So I might be able to get my surgery sooner than I thought.

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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💪
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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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