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Jan 2019 bypass buddies



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Saw my surgeon today and got my date.

17th Jan. Lapband removal, possible hiatus hernia repair and revision to RNY

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It looks like I am January too! I need for my new insurance to take effect January 1st. The coordinator said they will submit for approval the next business day. LOL

So not sure of a date, but I am RNY.

I am hoping that my husband will still be home and not on the road. He travels for work and is gone 7 months out of the year.

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I’ll keep my fingers crossed for you

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Thank you.

What is the process like to get approved in Australia?

As I am sure you have read on here, for those of us in the US it is all depending on the insurance you have and if your employer has the rider in the contract to allow bariatric services.

I am currently on my husbands insurance and they do not allow bariatric surgery. My employers plan does allow it though. So open enrollment is in a couple of weeks and I am moving from his insurance to my insurance. That will take effect the first of the year.

In the meantime, I made sure to choose a doctor and hospital that both insurances allow so i can at least get started in the process and not have to pay that much out of pocket.

Where I live, my house is in a fairly rural area. The hospital closest to me does not have bariatric surgeons. So my choices were to go about 50 miles south to Pittsburgh or go to another town about 30 miles west. I am going with the Dr and hospital just to my west. I like the Dr. and the office staff very much and it will be much easier for my family to get to and from that hospital than one of the ones in Pittsburgh.

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You have to have private health insurance as Medicare covers very very few procedures. I do know a few people that got a band that way but the process was long and arduous.

The insurers have changed the rules in the last couple of years , previously wls was part of most policies but because it has become so popular you now have to have the top ( most expensive) policy for it to be covered. Private health insurance policies in Aus are paid for by the individual not the employer. Even with insurance you still have to pay pretty substantial out of pocket expenses.

My out of pocket for the surgeon is $3000, anaesthetist $750, hospital excess $500 just to mention a few. That doesn’t include all the Drs and dieticians visits etc. It wouldn’t be so bad except I have paid all these fees before for my band, I feel cheated, I want a refund!

I also live in the country. The hospital I am going to is approx 40km away but that’s not an issue, I’m used to not having anything on my doorstep.

Now I had better get out of bed and get dressed, I have a dieticians app this morning

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Good morning Elcee!

Most insurance here is partially paid by the employer if you work. But for insurance to cover the WLS, the employer has to have a special rider on the policy. The insurance I am currently on through my husbands employer does NOT have it. So I have to switch to my employers policy that does have it. And you can only switch policies once a year, so i am pretty lucky that this all came up right as enrollment was about to happen.

I know my deductible is $2500 and then after that I pay 20% of all charges until I hit my max out of pocket of $5000 for the year.

I would be so frustrated having to pay all of that money and then have to do it again several years later. That is just horrible.

How did the dietitian appointment go?

Are you using the same Dr that you had the last time?

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Congratulations on your surgery date! I still have a few steps to complete before my claim (? I think that's what it may be called) is submitted to insurance for approval, but if all goes well, I am looking at a surgery date of mid to late January 2019.

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So....how did everyone do yesterday with all that candy sitting around?

I did HORRIBLY!

For starters, our landlord here at work brought us this BEAUTIFUL cookie tray. That was so hard to try and resist, so there I was having 2 Cookies.

Then coworkers brought in candy. Yep...had to have a couple of piece of that.

Then I got home and once again, yep had to have a couple of pieces of that.

Things that did go right?
I went to the gym on the way home and OH MAN did I ever have to talk myself into going. I didn't dial it in either, so that was good.

And the crap that I did eat yesterday, I did journal every morsel so at least there is that.

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Good morning January losers.

Yesterday was a flurry of activity for me.

I met with the NUT yesterday and had my psych eval.

I absolutely LOVE the NUT. She gave me so much information and truly presented it to me very easily. There are a few things that i am really going to have to work hard to get into a habit ahead of time so I am really glad that I met with her already. She will also be at several of the support group meetings that my Dr's office holds, so that will be great.

The psych was easy enough. We talked for a while and that was it. She was nice enough.

Anyway....time to work. yuck. Have a great day!

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Its good when it feels like the process is moving. Hopefully you will have that date soon.

I'm currently working on not drinking with meals - its a habit I got out of

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Sucks that insurance companies in the US don’t cover it 100% when it will save them money in long run.

In Ontario, the province in Canada that I live in, it’s 100% covered through socialized health care. However, though fully covered, the process takes about 1 year to go from referral to surgery date.

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I am not officially scheduled but I'm looking at a January surgery. I have had my nutrition visits, psych eval, etc and go in for my pre-op testing at the beginning of December. If my surgery is approved I'll see the dietitian one more time and get my pre-op visit scheduled. He does surgery on Thursdays with the EGD the day before.

It's getting closer and I'm getting excited!

Sent from my SM-N950U using BariatricPal mobile app

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I'm scheduled for January as well. Still seems so far away however I'm starting to get nervous. Have had most of my checks done just need to do my gastoscopy and phsy appointment. It's getting real now!

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