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Insurance woes 😩😩

RaeSavage

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RaeSavage    82

RaeSavage
Posted

Hello everyone!

I’m new here! So I’m anxiously anticipating the start of this journey. I have a consultation scheduled for 4/29 for a consultation with Emory Healthcare here in Atlanta GA. I have no idea what to expect. I recently realized that my Cigna insurance will cover 80% of this surgery. That’s all I know as of yet, but as I search the forums and do research I realize that I don’t have HALF of what other people have on this site. I don’t usually see a DR. I don’t even have a primary care physician. No medically supervised weight loss and no co morbidities. All that I have is a BMI of 43% PCOS and possible sleep apnea (fiancé wakes me up all the time because I’m not “breathing”). I’m concerned this will be all for nothing and I won’t get approved. I’m 32 and I need to nip this in the bud BEFORE I end up with co morbidities. Is there ANYone on this forum like me?

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Panda333    276

Panda333
Posted

10 hours ago, RaeSavage said:

Hello everyone!

I’m new here! So I’m anxiously anticipating the start of this journey. I have a consultation scheduled for 4/29 for a consultation with Emory Healthcare here in Atlanta GA. I have no idea what to expect. I recently realized that my Cigna insurance will cover 80% of this surgery. That’s all I know as of yet, but as I search the forums and do research I realize that I don’t have HALF of what other people have on this site. I don’t usually see a DR. I don’t even have a primary care physician. No medically supervised weight loss and no co morbidities. All that I have is a BMI of 43% PCOS and possible sleep apnea (fiancé wakes me up all the time because I’m not “breathing”). I’m concerned this will be all for nothing and I won’t get approved. I’m 32 and I need to nip this in the bud BEFORE I end up with co morbidities. Is there ANYone on this forum like me?

Hi, I'm older than you but similar and just started my journey a month ago. I am 48 with a bmi of 54. I have no co-morbidities but decided I wanted the surgery since I'm getting close to 50 and 150 extra pounds is hard on my short frame. My insurance, Aetna will cover 80% of the surgery also. (Just found out last week) I also didn't have a regular ;primary doctor but have tried and failed at diets for 25 years. What I did was establish a primary doctor relationship, had my first appointment yesterday. It was like, "hi, nice to meet you, can you sign off that bariatric surgery is necessary" lol And you know what? He did. He sAid that appointment could be the 1st of the 3 required physician monitored/supervised diets and he let me pick the diet, which I chose Keto. We then set up two more appoints, one for May and one for June. After the 3rd appt he will sign the letter of necessity. After you go to your consultation on 04/29 you will know more and they will assign you a patient advocate at Emory but it's a good time for you to establish a primary relationship in the meantime with a local doctor, preferably before your consultation. I hope this helps. I'm still at the beginning of this journey and

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GradyCat    3,697

GradyCat
Posted

I'm 53 and didn't have to have 6 months of weight loss management either. I just had to have the 40 BMI.

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RaeSavage    82

RaeSavage
Posted

On 04/18/2019 at 08:18, GradyCat said:



I'm 53 and didn't have to have 6 months of weight loss management either. I just had to have the 40 BMI.


Who’s your insurance company?

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GradyCat    3,697

GradyCat
Posted

15 hours ago, RaeSavage said:
23 hours ago, GradyCat said:


I'm 53 and didn't have to have 6 months of weight loss management either. I just had to have the 40 BMI.

Who’s your insurance company?

Humana Medicare Advantage plan.

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sshrader1208    16

sshrader1208
Posted

Hey there! I don’t have any co-morbidities either. No PCP here really. I used to see a doctor but he was really judgmental so I left. This is the first I’m hearing of needing to have a PCP?? My consult is this Monday.

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RaeSavage    82

RaeSavage
Posted

On 04/19/2019 at 11:10, sshrader1208 said:

Hey there! I don’t have any co-morbidities either. No PCP here really. I used to see a doctor but he was really judgmental so I left. This is the first I’m hearing of needing to have a PCP?? My consult is this Monday.
Well looking at other posts I see that this is the easiest way to get a letter of approval or recommendation. I have CIGNA insurance. So they require a stamp of approval from a doctor that has NOTHING to do with the surgery. So I got on Zocdoc last night and made an appointment today. Funny enough, it’s a doctor that I know personally 😂😂 That should help.

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RaeSavage    82

RaeSavage
Posted

On 04/19/2019 at 08:12, GradyCat said:





Who’s your insurance company?






Humana Medicare Advantage plan.


Human is pretty good. I’ve had them before. But this is the first time I’ve had Cigna. It just happened to be who my employer prefers. I’ll see how this goes.

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RaeSavage    82

RaeSavage
Posted

On 04/19/2019 at 11:10, sshrader1208 said:

Hey there! I don’t have any co-morbidities either. No PCP here really. I used to see a doctor but he was really judgmental so I left. This is the first I’m hearing of needing to have a PCP?? My consult is this Monday.
I had a doctor tell me that I wasn’t fat enough VERBATIM. At that time I was 240. I hopped on a scale yesterday and I’m 270. TWO SEVENTY!!! 😞 I’m 5’6. So I decided to change my pcp totally. Hopefully I have a more understanding relationship with the new one. I know him personally anyway. 🤷🏾‍♀️

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Go To Topic Listing Insurance & Financing

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    • Alisa_S

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      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

        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

      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

        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

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.

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