Some more insurance questions

[Katie Loesch-Meyer 71]

Hi all, I'm new here. I am investigating surgery, probably roux-en-y because I have pretty bad reflux already and that's the surgery that is supposed to help fix that. I've called my insurance several times, and finally, after 5 different people have a printed list of what the qualifications are! And, I meet them! It says BMI of 40 or 35 with comormidities. I have a BMI of 40 and GERD, which they specify as one of the comorbidites. Then is says, "documentation of weight management attempts, and inability to sustain weight loss." I am printing out past weight watchers billing reports, and Jenny Craig is sending me something as well. I'm thinking that should work? It doesn't say it has to be medically supervised, or give a length of time. Then it just says I have to have a dietary consultation, and a psychological evaluation, which sounds pretty standard. And "No history of drug or alcohol use, or drug and alcohol free for greater than one year." I have had a few drinks, but honestly, other than one or two occasions haven't had a full drink in at least 3 yrs.....not because I hate alochol but when I'm supervising my kids I don't have time for booze, lol. Would it be unethical to say "no drinking" when I've probably drank once in the last few years? I can't imagine it counts that I've had a sip of my husband's drink, or 1/4 glass of something here or there sporadically. I imagine they are just ruling out any chances of alcholism.

[samuelsmom 670]

. And "No history of drug or alcohol use, or drug and alcohol free for greater than one year." I have had a few drinks, but honestly, other than one or two occasions haven't had a full drink in at least 3 yrs.....not because I hate alochol but when I'm supervising my kids I don't have time for booze, lol. Would it be unethical to say "no drinking" when I've probably drank once in the last few years? I can't imagine it counts that I've had a sip of my husband's drink, or 1/4 glass of something here or there sporadically. I imagine they are just ruling out any chances of alcholism.

I believe you are correct that they are looking for people who abuse alcohol. Your couple of drinks should have no bearing on your being approved. The nurse who took my history found it extraordinarily amusing when I told her that enjoyed a wine cooler every year during the Super Bowl!

[Katie Loesch-Meyer 71]

. And "No history of drug or alcohol use, or drug and alcohol free for greater than one year." I have had a few drinks, but honestly, other than one or two occasions haven't had a full drink in at least 3 yrs.....not because I hate alochol but when I'm supervising my kids I don't have time for booze, lol. Would it be unethical to say "no drinking" when I've probably drank once in the last few years? I can't imagine it counts that I've had a sip of my husband's drink, or 1/4 glass of something here or there sporadically. I imagine they are just ruling out any chances of alcholism.

I believe you are correct that they are looking for people who abuse alcohol. Your couple of drinks should have no bearing on your being approved. The nurse who took my history found it extraordinarily amusing when I told her that enjoyed a wine cooler every year during the Super Bowl!

Haha! I'm not against alcohol, I just have been pregnant or nursing for the past 5 years, so that limits things quite a bit. And when you are chasing the kids, turn around, and your drink is now warm and flat, you have no desire to finish it. Plus, I'm always dieting and it is too many calories. The only indulging I have had is special occaisions, and man I regretted the champagne I had, felt like crap the next day. My husband had the same amount and felt fine, I just don't do well. I'm too darn old for booze!

[Crosby 303]

Just be honest...it will be much easier to remember. I told them my drinking is totally based on seasons which is true. Fall and Winter maybe one or two the whole two seasons. Spring..maybe one or two. Summer..weekly...margarita queen!

[amylynns 802]

I was about a once a month drinker and it had no bearing on getting approved at all.

I believe also, they're looking for abuse of it.

I got approved with BMI and GERD as well. Although, I do have to say, I still have some GERD. I am quite upset by this in fact. That was honestly one of the biggest reasons I chose bypass over the sleeve. I'm going to chat with my Dr. again at my 6 month check up about it. I don't eat late at night--I'm obviously not over-eating at all, so I don't understand it at all.

But anyway--good luck to getting approved!!!

[beachgurl84 456]

I told my doc I had the occasional drink, average 1-2 a month maybe, and they had no problem with it. If you have so few it's almost nonexistent I would just say you haven't had any. I will throw in there that I had GERD and I chose the sleeve. I'm still on medication (protonix) but I haven't had any issues since surgery. Mine was always mostly controlled with diet though and the healthier choices I'm making sense surgery have definitely had a positive influence on my GERD. Sounds like you've done your research. Good luck on your journey!

[NikkiDoc 312]

I had GERD pre-op that was mostly controlled with Nexium. I still went sleeve since the surgeon was fixing my hiatal hernia at the same time. Still on Nexium but have had no reflux at all since surgery. So it is definately better post-op.