Commonwealth Care...BMC Healthnet....Masshealth Anyone?

goalechica
on 1/1/09 8:44 am - Waldorf, MD
Christine,

Nice to meet you! I'm suprised by how hard it's been to find other BMC healthnet members as well! I have Commonwealth care as well. Not actual masshealth. But the standards are similar I believe. I am at the lowest tier though. No copay for appts. just a low copay for RX. Is that the same as you?

I'm excited to meet someone else going through the same program and insurance as I am. I've heard some great things about Dr. Hess and his "cute" nurse Tony. Sounds like a wonderful team. How long did it take you from initial consult to getting a date, and have you already been approved?

My AIM name is Goalechica so feel free to add me to your buddylist. Also you can e-mail me at [email protected].

I'm hoping I can get this process underway as ideally June or early July would be best for me as I'm a full time student and need to do this in the summer. Looking forward to talking to you more!

Jenna

Starting Weight/ Surgery Weight
        255                   237                     

            
(deactivated member)
on 1/1/09 9:04 am
Hey Jenna, Added you to my buddy list. Yes I am on the same tier plan as you. Sounds like we have a lot i common. I am going to be a nurse so I am in school as well but I am taking Jan-September off so I can get this surgery situated since I have to miss a semester sometime anyway because of how the classes go.

I got all my documents from my pcp in early NOV and actually med with Stephanie Spaide at the weight loss management center (where you will go for all appts). She put me on a diet plan to help with the required 5-10% weight loss pre- surgery. Even though I hadnt been "in" the program yet, it was documented that I started so my weight is there in the file as starting on NOV 26th, the day I met with her. You do not have to meet with her at all. I just chose to.

On 12/4 I met Dr. Hess, Dr. Baranov (Internist that works with Dr. Hess), and Tony. This was considered the initial consult although I had most of my information before then it was great to meet them and they gave details of what I should expect. They determined I was a good candidate based on my weight. I dont have any co mobidities and I am young so they think I am ready for it. Although I went in wanting the lap band, I have recently changed my mind and DONT want it. Dr. Hess pushes the RNY more anyway and I think thats because so many people want revisions from a band down the road. Also the weight loss is more with the RNY with rather than the band and so since i have ALOT to lose this is overall a good decision. So this is officially the start of my process.

The next step was for me to have my diagnostic testing. They require and EKG, pulmonary functions test, chest xray, and full blood labs. I believe depending on age and if you have co morbidities they may also require you to have a sleep study and to see a cardiologist as well as a mammo... but it all depends on what they think you need.

I then met with Dr. Lalita who is amazing as well. She is the nutrition DR and gives your your physical and will also help to determine if you are a good candidate. She goes over the tests results and discusses everything. I am all in the clear except I have to raise my iron levels in order to get the RNY. I hope that I can do this!

I am meeting with Latita again this coming week so she can actually give me an rx to help with the iron.

I met with Wendy this week too and she really put me at ease as well. The entire team is wonderful to deal with. Even the receptionists are so pleasant. You wont ever feel uncomfortable there.

I will meet with Wendy one more time and taking my MMPI psych test, both happening in FEB.

After all this (and its goes quicker than you think!) They will send in my information to BMC healthnet. The MMPI takes about 4 weeks for the results to come back which will be about the beginning of march. BMC healthnet has 14 days for approval. No one has said I have a chance of not being approved and that sine we are at BMC, which is that insurance... not to worry... So that is why I am looking at mid march.. I dont have a date set but it is safe to say.

This is definitely a journey to remember and already has been harder than I thought. The pre-op weight doesnt come off easily and I commute over an hour to go to the appts but int he end I think it will be all worth it and I cant wait. I do get emotional over it because I want this more than anything and I am nervous about it as well. Even though Im going to be a nurse I am a HORRIBLE patient and dont like the roles reversed! LOL

Typically, it takes about 4-6 months for the process between all the appts and meeting you must go to plus weght loss. Also try to NEVER cancel an appt because they are VERY hard to reschedule, in fact if you miss you may be looking at delaying another month. The practice is HUGE.

Just an FYI I am not sure what day your first appt is but if its on a first or third Thursday of the month you may want to stay for the meeting with Wendy. They have a bariatric meeting in the newton pavillion building and its soooo informative. They have a clothing swap and also many PTs there that have already had it as well a sme who will be in the same boat as you! I hope to meet you there sometime! As long as the weather is good for me to travel there I will be there at every one. They discuss the issues with the surgery both good and bad and Wendy gives priceless information.

I think I have covered everything, sorry for the book! This program is one that is unlike the others becaue it doesnt require a 6 month weight management as some insurances do. But still rest assure that this facility is a center of bariatric excellence, which is great. I have no doubts about Dr Hess!
irenethebean
on 1/2/09 5:51 am - foxboro, MA
Hi there..I just wanted to add my two cents in and say that as i've also told Jenna in other posts..Dr. Hess is an amazing person/surgeon.  You will both be in very good hands.  Good luck, and again, let me know if you guys are going to any of Wendy's support groups.  I'd love to meet you guys there and get to know each other in person.
kristim
on 10/30/13 3:29 am

I am curious - I am on mass health as a result of being Laid off - Did Dr. Kruger require your to pay a program fee ($300 approx.) to start exploring the surgery - I am on Mass Health and can not afford this payment.

 

evie_617
on 6/9/10 12:52 am
I can't even describe how happy I am  to find  someone else with the same health plan and questions I had but  couldn't  get  the answers to. Thank you so much  for all the  info you guys posted,,,, How long the the whole process took before the surgery? please tell me about the psych interview?

                         Thanks
Good Morning Everyone,
                   I'm new to this site  so I need lots of help,,,I am going to my first Dr visit for my  lapband surgery. I'm a little nervous. I really want  this surgery but I'm not sure what are  the right things to say,,, help!
lopes2244
on 4/19/11 12:36 pm - MA
i bmc and im seeing dr.kurger in wareham very nice doctor
krisbee
on 6/22/10 6:54 am - Boston, MA
Hi my name is Ana i seen your post as i am new to the page. I'm also a Dr.Hess patient im just waiting on my pshyc evaluation. im hoping to find some supporting friends to go through this journey. Im also worried about what insurance is going to say so i hope to read more of your post regarding this post. thanks
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