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Hey, yall! I'm Andi from Tampa and I recently started thinking about and researching the gastric sleeve surgery. I'm 5'4.5" and weigh around 215-220 lbs. My BMI is around 37.7. No comorbidities but have a family history of diabetes, high blood pressure and heart disease. Of course, this worries me since I'm so overweight. I do not want any of those diseases and would like to be proactive about my weight/situation.

I called my insurance UHC to see what the requirements are and how much would it cost. I was told that my BMI was in the range but without any comorbidities or having a BMI of 40, that I was not eligible. I asked to see if I could possibly get my doctor to help get it approved. UHC said that my doctor would have to do a peer to peer review with them in order to try and get it approved.

I have an appointment with my PCP on Thursday so I'm hoping she'll be able to do a peer to peer then.

Any suggestions or advice on how to help get this approved and get the process started?

Thanks!

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Hey, yall! I'm Andi from Tampa and I recently started thinking about and researching the gastric sleeve surgery. I'm 5'4.5" and weigh around 215-220 lbs. My BMI is around 37.7. No comorbidities but have a family history of diabetes, high blood pressure and heart disease. Of course, this worries me since I'm so overweight. I do not want any of those diseases and would like to be proactive about my weight/situation.

I called my insurance UHC to see what the requirements are and how much would it cost. I was told that my BMI was in the range but without any comorbidities or having a BMI of 40, that I was not eligible. I asked to see if I could possibly get my doctor to help get it approved. UHC said that my doctor would have to do a peer to peer review with them in order to try and get it approved.

I have an appointment with my PCP on Thursday so I'm hoping she'll be able to do a peer to peer then.

Any suggestions or advice on how to help get this approved and get the process started?

Thanks!

Oops I forgot to mention that I work an overnight shift as well - so trying to loose weight has been a battle and the weight is winning.

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You might want to ask them what your out of pocket costs will be even if you were approved. Even with insurance and dediductables and co-pays it was cheaper and easier to go to Mexico. Not say you should, but it's worth asking.

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You might want to ask them what your out of pocket costs will be even if you were approved. Even with insurance and dediductables and co-pays it was cheaper and easier to go to Mexico. Not say you should, but it's worth asking.

They've already told me the out of pocket costs, which is less than $1K. I wish I could go to Mexico LOL, but my husband is active duty and I have the kids alot of the time.

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Hi there- I'm new to posting here as well!

I also have UHC insurance. I had to contact Optum Health through UHC and a registered nurse walked me through the requirements over the phone. My BMI is 40 but they did explain that you need a comorbidity if it was under.

You may want to check if you have sleep apnea or something like that. My PCP says that most overweight people have apnea at some level.

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Hi there- I'm new to posting here as well!

I also have UHC insurance. I had to contact Optum Health through UHC and a registered nurse walked me through the requirements over the phone. My BMI is 40 but they did explain that you need a comorbidity if it was under.

You may want to check if you have sleep apnea or something like that. My PCP says that most overweight people have apnea at some level.

@lisp I'm going to try and get my doctor to refer me out to get the sleep study done to see. I'm prediabetic according to the latest blood work but I'm not sure if that qualifies as a CM

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I'm not sure either but hopefully your doctors office will be familiar with UHC and their requirements!

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I'm not sure either but hopefully your doctors office will be familiar with UHC and their requirements!

How's your journey, llsp?

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I'm not sure either but hopefully your doctors office will be familiar with UHC and their requirements!

How's your journey, llsp?

It's really just starting, I'm not even sure I feel like I'm on a journey yet. I will tell you though for the first time in a long time I am really optimistic about the future and looking forward to something. It sounds so weird to be 'excited' for surgery but I read so many uplifting posts here with different peoples successes and I'm excited for all of us!

I had my third of 6 monthly check-ins in December so I am getting closer. I actually gained weight from my first weigh-in to my second so my goal right now is to work to shave off those 6 lbs for my next visit.

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Isn't it great to regain your hope and optimism? Have a very Happy New Year!

Honestly yes! I haven't even shared my intention to have surgery with anyone in my life yet so it's been this secret well of optimism inside I go to when times are tough or stressful lately.

I love reading your posts btw. Thank you for all the positivity! Happiest of New Years.

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I'm not sure either but hopefully your doctors office will be familiar with UHC and their requirements!

How's your journey, llsp?
It's really just starting, I'm not even sure I feel like I'm on a journey yet. I will tell you though for the first time in a long time I am really optimistic about the future and looking forward to something. It sounds so weird to be 'excited' for surgery but I read so many uplifting posts here with different peoples successes and I'm excited for all of us!

I had my third of 6 monthly check-ins in December so I am getting closer. I actually gained weight from my first weigh-in to my second so my goal right now is to work to shave off those 6 lbs for my next visit.

Awesome! Wish you best of luck. I'm just hoping for an approval year too. Here's approvals, successful surgeries and losing weight!

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

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • 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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