Okay, Now I am ready...

Effective Jan. 1, 2005 I will become insured under BCBS-HMO of which surgery is covered. My first question is ..what do I do now while I wait until January? and my second question is ...I need a PCP in the Atlanta or surrounding area who supports WLS. Can you please provide me with a name? I want to be a looser so bad!! Thanks.

Congrats Phyllis. Sounds like you and I were in the same boat. I decided in January of this year I wanted the surgery but knew I would have to change insurance to pay for it. Open enrollment for me was in April-May for a July 1 start date. First off, I knew my PCP was on the HMO list and that's where I started. I made an appointment with him explaining what I wanted to do and what tests I knew would be needed prior to surgery. He told me he could get all those tests done prior to July 1 in a manner so that my current insurance would pay for it. He said with all the co-morbidities that I had, I needed all the tests whether I had surgery or not. He scheduled for me a sleep study, an endoscopy, blood work, Pulmonary Function Test, EKG, thyroid panel and something else but I can't remember now. I also was lucky that the nutritionist with the hospital did my consult free of charge. So by July 1 I had had all of the testing done. By July 5, I had had my psychological eval and was ready to submit. It took about 15 working days for my claim to be processed and approved. I got a surgery date within 2 weeks of approval. My PCP has been the key for me. He is so very supportive and very thorough. Once I was approved, I had to have a chest x-ray and a stress test (which was worse than the surgery). I hope this info helps. My 'mad methods' seem to work for me - here I am 2 weeks post-op. Good luck in your journey and if I can help, let me know. Robin

Where do you live? My PCP is J. Thomas Taylor and he is in the Vinings area and he is on the HMO list for BCBS HMO. He was very supportive of my decision and his staff is wonderful. They typically refer to Dr. Duncan even though I chose Dr. Burrowes...he did the refferal for me and faxed it over within 24 hours. Best of luck, Shree

Hi Phyllis, I did the EXACT same thing LAST year. In the meantime, I went ahead and got my sleep study done, and found my surgeon and went to the "informational "meeting for my surgeon (I don't know what area of town you are in..I live in Duluth, and used Dr. Robert Richard in Gainesville of Obesity Solutions...he was FANTASTIC!) I went to my PCP and got his buy-in to my surgery desire, and he had me go do some tests he wanted me to do...some of which were things BCBS HMO required, so I already had them done. OH..and go ahead and call the surgeon's office you want to use, and make an appointment for as early in January as you can, so you can get moving asap...the sooner you go in for your consultation, the sooner you will be able to get rolling on fullfilling the requirements. I WISH YOU THE BEST OF LUCK!!!!!!!!!!!!!!! -Tami

Thanks you guys for the advise. Here is my dilemma... I am currently insured with Kaiser Permanente who does not cover WLS. In January I will be covered by BCBS-HMO. Can I start my tests under Kaiser and will they pay for them or should I wait and have the test done under BCBS in January? SO many questions.. but I need to know. I asked my PCP at Kaiser years ago that I wanted WLS but my PCP talked me out of it and wanted to try diets.. Now when I became adamant about it, they tell me that it is not covered and never was covered under my employer.. What a waste of almost 7 years! Now I am full throttle ahead!!