Recent Posts
Topic: RE: Countdown Question
Great question, Louis. I decided in August, 2003 that this surgery was the route I wanted to take, and I found out that my insurance, Aetna HMO, did cover it but I had to do the required 6-month supervised diet deal. I researched and tried to find a good surgeon, and then in December, 2003 started my 6-month plan.
Wouldn't you know, in February 2004, Aetna changed their rules where you only have to do a 3-month plan?! However, I was grandfathered in under the other plan, so I had to do the six months.
The Aetna information stated that I could submit for approval after three months, with the understanding that I had to complete all six months prior to having the surgery. In April, I chose my wonderful surgeon, Dr. James Davidson in Dallas, and his office submitted for approval.
I was denied, with Aetna saying that I hadn't completed all six months. Well duh! I knew that, but I had also been told that I could pre-submit. I was disappointed but not defeated.
We resubmitted in early July upon completion of the whole six months, and the waiting game began. I left town early in the morning of Tuesday, July 27 because my dearest friend who lived out of town was having a baby. I was gone from work Tuesday and Wednesday and made a point not to check my work messages, because I didn't want to deal with work during such a neat time.
When I got home late on July 28, there was a letter from Aetna in the mail, and I nervously opened it. I had been approved! I was beside myself, completely. I couldn't get over it. I had wanted this for nearly a year and the reality was finally here!
What's funny is that when I got to work the next day, there was a message on my voice mail from the surgeon's office, saying that I had been approved. That call had come on Tuesday, so I would have known the whole time I was out of town, had I checked messages. However, opening the envelope was like nothing else, so I'm glad I didn't know!
They were able to schedule my surgery for August 12, just two weeks after I learned that I was approved. Those two weeks were like an extended Christmas Eve. I was so fortunate and excited!
I'm very lucky that I was approved in 2004, because Aetna no longer covers the surgery unless the employer buys separate coverage for it, and it's too expensive for most employers to add on. I really feel like I was supposed to have the surgery when I did. So blessed!
Sorry so long, but that's my story. Thanks for the fun idea, Louis!
Everyone have a great weekend.
Kathryn
Topic: RE: Countdown Question
my approval was tough. blue care network is one of the hardest to be approved. They deny everyone, then most who persue it further get it approved in an in person appeal....well you have to have i think it was three denials first. well i had no diet attempts in my chart so that was the reason for denial. well at the in person appeal i told them it was not my fault my pcp didn't document it (actually i was fibbing, i gave up on diets long ago) and they sent a letter to me five days later saying i was approved.....i am actually very glad it took so long, it gave me a chance to find the oh message board and learn so much and make such great friends.
did you graduate from high school or college? Sorry, i'm having a blonde moment.
hugs
Linda
Topic: Countdown Question
What was your experience with the surgery approval with the insurance? I personally had no problem. The one funny thing was that I postponed my surgery from June 2004 to August 2004. I was going to graduate from school 2 days after the surgery. The graduation was going to be in a small football stadium. I had to walk down to the grass field from the bleachers. I ended up rescheduling the surgery. When July came around my aproval had expired. I forgot to tell my doctor to ask for a new aproval for the surgery. It was no problem. The funny part would be to arrive for the surgery and be told that my insurance had not aproved it.
Topic: RE: Coutdown to the big day
Linda, you gave me a great idea. The first message will be concerning the surgery approval. Thank you. Thank you for the idea.
Topic: RE: Coutdown to the big day
This is cool. i just realized that on july 6 2004 i got my approval letter for surgery. I fought my insurance for a year and finally won with an in person appeal. I was so happy that day and went out for dinner to the buffet.....i could never do a buffet now, but do go with my kids and order soup.
Topic: RE: How was your holiday?
Linda, can you tell me what is LMAO? I have retired from drinking. I can only drink 1 or 2 drinks max. Either I get wasted very very soon with 1 drink or since our stomach is so small I get full so quick. A couple of months of go I went to a wedding. I wanted to try drinking as much as I could handle without making a full of myself. Well I got full before I made a full of myself. I did get your e-mail about the pictures. Maybe you could have told your hubby to take a picture of you when you were plastered. Then put it on the message board. The message would say Plastered Pictures. Just a joke. Always happy to hear from. Take care.
P.S. I have posted a new message. Let me know what you think.
Topic: Coutdown to the big day
I would like to get your input, information, opinion, ideas, messages, and anything you would like to say or write. We all had our surgery done on August 2004. Our 2 year anniversary is coming up next month. I feel that it would be nice if for the month of July we posted messages referring to what was happening on July 2004 and before that. If anyone has a better idea, question or comment, that is great. I know you will have a better idea than mine. I just want to get the ball rolling. Then in August, we can write about the surgery and our new beginning. I hope there will good input, so that we can continue educating and learning about ourselves. Let me know. Take care.
Topic: RE: How was your holiday?
LMAO you are so funny. I am so retarted when i drink, so i wait til everyone else is drunk before i start.....they always try to get me to start sooner, but i won't. They think i'm the life of the party. So anyway, i seen most of the fireworks before i was plastered.
Did you get my emails about how to put your pics on here?
Hugs
Linda
Topic: RE: How was your holiday?
Linda, you had a blast and was plastered. We are all happy you had a great time. It sad how some old friends could be jealous of your new look. We are jealous we couldn't be there with you. All that food, fireworks, friends, and drinks, makes a great holiday. Was the fireworks awesome because of the 3-D glasses alone or because of the glasses with the barcardi? Just kidding, so happy you had a great time.
Topic: RE: One pound from Goal!
Congratutations on almost reaching your goal. We are all so happy for you. There is only one problem. WE NEED PICTURES. We want you to share your beauty with all of us. Once you reach your goal, there will be a new goal. Keeping the weight. We are all cheering for you. We will always be here when you need us. Good luck and take care.