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Lovely77

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Lovely77    5

Lovely77
Posted

Hi everyone. I'm new here. I'm considering either gastric bypass or sleeve. I have my very first appt with a surgeon on 10/5. I'm hoping my insurance will approve me. I have Empire bcbs. Does anyone else have this insurance? Any advice to get myself approved?

Sent from my SM-G955U1 using BariatricPal mobile app

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Diana_in_Philly    1,426

Diana_in_Philly
Posted

The best way to find the requirements for your surgery is to go to the web site for your policy and search "bariatric" to see what comes up. There should be policy guidance which lists the requirements. Some require a history of trying to lose weight (doctor's records can be enough), others require a monitored weight loss plan - often your surgeon's office already knows the requirements because they do this.

Do make a list of questions you want to ask your surgeon. Consider bringing a trusted relative or friend with you to the appointment. My first consult was 3 hours and had to be done after attending an informational seminar at the hospital. There was a lot of information to digest (no pun intended) at that first meeting, so having another set of ears around doesn't hurt.

best of luck.

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ColleenErin1974    195

ColleenErin1974
Posted

57 minutes ago, Lovely77 said:

Hi everyone. I'm new here. I'm considering either gastric bypass or sleeve. I have my very first appt with a surgeon on 10/5. I'm hoping my insurance will approve me. I have Empire bcbs. Does anyone else have this insurance? Any advice to get myself approved?

Sent from my SM-G955U1 using BariatricPal mobile app

I agree with Diana_in_Philly. You should go online or call to see if your policy covers the surgery. I called mine and when they said it was, I asked if there were any pre approval hoops to jump through. For me, I had to have 3 months of a supervised diet with my PCP. Most insurances require 3,6,or 12 month supervised diets. You will also have to have testing, lab work, and appointments with psych and a nutritionist. It usually winds up being a year long process.

Another good thing to do is research everything you can on both surgeries. This site sells 2 books I found helpful. One is all about the sleeve and the other is about bypass. They have a ton of information and helped me decide what to do. I had the gastric bypass and love it!

Its also a good thing to start weaning off soda or any carbonated beverages, junk food, sugar, Pasta and rice. This will help you start slowly into your new lifestyle change and may help start your weight loss.

Good luck on your journey! Keep us posted!

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Mhy12784    423

Mhy12784
Posted

I have empire bcbs and I'm expecting my approval any day now. 3 months of weights is all I was told I needed. I'm curious where were you looking at going?

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Lovely77    5

Lovely77
Posted

I'm probably going to have it done in Middletown. How about you? I hope all they will require of me is 3 months! I've heard of people having to wait 6 months or even a year!

Sent from my SM-G955U1 using BariatricPal mobile app

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • KeeWee

      KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.

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