Should I wait?

I was wondering since its already Sept. Should I wait till Jan to pursue WLS? Will that be best for the insurance since everything starts back up new on Jan 1st? Or should I go ahead and get started. Advice please, what would you all do?

girl go for it. it's going to take a while to get all that needs to be done. why wait when you can get it all done. if you are waiting because you aren't sure then yeah wait, but if you know you want this then go for the gold. i think that you would be better off doing all now and not waiting. julie

I would definetly go ahead and begin the process--if for no other reason than come January 1st your insurance could have changed the requirements for WLS or they may not even cover it at all!!  A year ago I was working at a place that covered WLS if you had 12 months of documented diet (in addition to other requirements)  and  10 months into the 12 months was January and the insurance suddenly required 18 months of documented diet PLUS several other requirements--so get going now and hopefully the requirements will stay the same--if they change at least you will have that many months already under your belt!

Oh yeah I SO SURE i want this. lol....Ill go ahead and get things going. Thanks you guys are the best  

id go ahead and start the process---what dr are u going too? have u decided? dr evanson is a great dr-and his process seemed to go by pretty quickly too--he never really required much from me he never required a documented weight loss (unless some ins co do?) but i know i didnt need that all i needed was a referal from my family dr-i went to the consult-went to psych apt-then they called with a date then went to pre op class and medical xam ----but id defintly advise u to start sipping once u have a date because that was my mistake i didnt know what i was getting into and then boom look at me now i struggle each day on fluids might be better to start before surgery that way ur already in the habit know what i mean? but if u start the process now hell u may even get to have the surgery still this year? donno 4 sure but id defintly not wait------keep in touch ok loves ya

It usually takes abou 6 months to have surgery once you start the process if you have everything that your insurance requires so you should definitely start the process now... and plus if you get approved before christmas the approval is good for 6 months at (Most) insurance companies so you can wait and have the surgery at the beginning of next year when your deducitble starts over...

Right now im looking at Dr. Evanson & Dr. Jones. Not sure which one yet. I live about an hr from Indy so I want one in that area. I could go to Illinois but the drive would be like 3 hrs. What has been everybodys out of pocket for the RNy if you dont mind sharing. I know it varies. But I need a general idea. Our deductible is 600.00

That is going to depend on your insurance policy. Many pay 100% of surgeries, hospital stays, etc and 80% of out-patient. Others, will pay for a flat percentage. Some will make you fulfill all of your deductible and then go by whatever percentage. Mine paid 100% for EVERYTHING for the first year. After that, I've had to pay 20% of my anual check-ups (about $20 out of pocket) since by September, we have FAR exceded our deductible amounts (individual & family). Check with your insurance on their policy. BTW...it is Indiana LAW that insurance companies can only require 6 months of supervised dieting now. That came into effect June of 2006. By now, all insurance companies should have updated their contracts with employers so that law should be in effect for all of them. So..no more 12 month or 18 month requirement. That isn't to say they can't require other things to make you jump through hoops though. Don't sweat it, it's just their way of ensuring that you will stick with it. It's frustrating, but unfortunately, common. I agree with everyone else, go ahead and get the ball rolling. You may be pleasantly surprised and be able to get your surgery in 2007....which, if they make you pay your deductible first, you probably already have it paid by this late in the year and it would go straight to their policy on percentage coverage. Sometimes (like my insurance), once you reach a certain dollar amount of out of pocket for the year, they will forego the 80% policy and pay at 100%. Confused? Here's an example based on my policy: Individual deductible is $200/person or $400 per family. Maximum out-of-pocket expences for the year is $3,000 (I think). 100% of surgeries, surgeons, in-patient care is covered. 80% of office visits and out-patient care is covered. Scripts are covered with a co-pay of $10/month for generics, $30/month for name brand. Bill and I have each paid the $200 deducitbles this year so the individual & family deductibles are covered. After they were paid, then the insurance started paying office visits, etc as outlined above. Between deductibles, 20% for office visits, and script co-pays, we have now paid $2832 out of pocket. After we pay $168 more, everything will be covered at 100%, scripts and office visits included (just in time for the new year and it start over at $0 out of pocket). Anything not covered by them  (like my Lasik eye surgery) does not count toward their out of pocket records. Which, that sucks because the Lasik was close to $4,000 and my plastics, $9,000. However, those expenses WILL be allowable on our income tax this spring as a deductible there. So...call your HR at work or call your insurance and get the scoop on how they break things down. Good luck! Sherri