I am just starting my journey. I have Humana Gold PFFS and wanted to know if anyone else had the same insurance and how long did it take for the process beginning to surgery date? Thank you,

Shanika

Shaydigga first congrats on your choice to be healthy, I do not have the insurance your talking about but make sure you check to ensure they cover your procedure GeForce you get started. You will read on her that some people have gone through programs and then was informed their insurance doesn't cover their surgery. Good luck.

I am in the second month of my 6 month weight loss program i have medicare/medicaid and the medicaid requires the 6 month weight loss program i also have to see a dietitican and go to behavioral therapy

I'm pretty new. I will be having surgery in July ..I am in the midst of many appts this week and next week

I am also pretty new at this. Got my first appointment of 6 months on Tuesday and several other exams next week....starting with sleep test! pretty excited! wished I would have looked into this a long time ago! Lap Band

I started the journey last month.. Def call your insurance, each carrier may have different requirements.. Mine requires 6 months of clinical nutrition visits and a psych eval.. I've had the eval, an endoscopy and upper GI already.. It's a lot of things to cover, but I think it's important to take each step as it comes.. By the time everything is completed I know I will have made the right choice and be ready for the next chapter

I am new at this as well.....sort of. I went through all of my pre-surgery tests/appointments the end of 2013 only to be denied because I didn't have any comorbidities and my BMI was at 39 at my first appointment. By the time I was done with all of my testing, my BMI was 40 but it was too late. I didn't know going in that my insurance (BCBS) only uses the first weight/BMI for consideration. I had to start over, having to go through the six month appointments with my primary physician. This was not a requirement when I first went for approval. I was upset at first but believe that everything happens for a reason. The appointments with my primary helped me understand the process and get me on track for this awesome adventure. I just completed my sixth appointment and have been submitted to insurance. Keeping my fingers crossed that an approval comes my way this time.

I also have had my first appointment and was 39 bmi. Plus I have anthem bc/bs. Since that appointment I've been trying to gain 5 lbs before my next appointment. Are you saying I'm screwed? Lol

How disappointing that they go from our first weigh In. The only thing saving me is a sleep study " come one sleep apnea!" Lol

I don't have any co-morbidities either.

What a bummer.

For the first time in my life I'm just not fat enough

@tfarr....I sure hope not. It seems that everyone has had different experiences. I can say that for me....I had the same feeling....not fat enough, which is just CRAZY! At the time, I was pre-diabetic and that still wasn't enough. Check with your doctors office to see what weight they submit for approval. Most of what I see here is the first weigh in but you should confirm with your bariatric coordinator. Good Luck with your next steps!

Thank you MickeyMouse68, I will have to check on Monday. I got fasting labs done last Saturday

And they still haven't got those, so I'll be calling Monday. Thank you

I'm about half way there. I have sleep apnea test to do. I am in the parking lot as we speak lol. Blood tests and nutritionist consult that's it. Oh and they want to remove my gallbladder prior to the sleeve surgery. Yay me. Two surgeries! This is my second attempt to do the sleep test. The first time no one showed up. I sat in a dark parking lot all alone waiting for the tech and took sleeping pills so I would be sleepy. Waited an hour and a half and finally left! Guess I'll know in 10 minutes if it's a go tonight. Better be. Not a side of Vegas someone wants to be alone in!

Oh boy! Two surgeries? Lucky you lol

Good luck with the sleep study.

I hope they show up this time

I have UHC with the Optum Bariatric Resources Program. So my physician/hospital choices are extremely limited. There are approximately ten hospitals in my area, but I can only use one of them per the plan and I'm not going to Tampa General. I can do better for a $3000 deductible.

Other than that, my requirements aren't bad: 6 months of nutritional counseling and a psych eval. I go for my third visit on Thursday. So I'm projecting a July surgery date. Nutritional counseling of course isn't covered by the plan, so I opted to use the RD sessions offered at Florida Hospital's Wellness Center -- 6 sessions for $250.

Next, I have to go see my Hema/Onc to develop a strategy for surgery bc of my bleeding disorder and then take care of the psych eval. I'm scheduled to go back to my surgeon for the pre-op right after my last NUT visit late June. I'm anticipating a three business day turn-around for the approval.

Ally

I have humana ppo and medicare I only have 2 diet visits but psych eval has a 150 copay so that has slowed me down

I do not have to take sleep apnea test or upper G.I. I do have to have a letter by my PCP, attend a seminar, see a nut., get a psych evaluation...but I do have to do a six month access chart where I'm supposed to diet and I'm monitored, but my I insurance doesn't require me to lose any weight...I'm very early in so I will update! I'm glad to know my first weigh in tomorrow is what my insurance will go by, in case, I lose weight

Yeah my psych evaluation is 50 and nut is 75. But that's it . Everything including surgery is 100% paid. Just got home from sleep study. It's hard to fall asleep on my back and with a stranger in the other room watching you. Lol he said results in one to two weeks and he's about 90% positive I don't need to come back. Now nut appointment and blood work and my list is done. Yay