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Topic: RE: Approval
I have BCBS as well and my BMI was 35 when I got approved. I did have 2 co-morbidities but also had separate letters from my physician and my surgeon stating how losing weight would dramatically improve my life and that the surgery would benefit me. Did you have any doctors write letters for you to the insurance company? I have also heard that writing a letter yourself to the insurance company can help too. I truly hope it all works out for you. Keep us posted.
Jessy
Jessy
Topic: RE: Approval
Would a second co-morbidity give you an edge? Like high cholesterol? Or sleep apnea? Or gerd? Just trying to help. It's awful to need/want this life affirming surgery and have the insurance company deny it.
5'5" Age 63 HW 212 SW 200 Currently 8 pounds below goal
Jacque 
Topic: RE: Approval
I have BCBS. BMI of 40 or more, mine is 36.5 and 1 co-morbidities for 2 years. I have high blood pressure for the last 2.5 years.
Topic: RE: Dr Joya
Are you having VSG or RNY? I know there's always a lot of talk on the VSG forum about surgery in Mexico. There may well be on the RNY forum, too, but I don't go over there. Check out the forum for your surgery type and ask. You'll get a lot of responses, I'm sure.
The 2 names I see all the time are Dr. Alvares, and Dr. Aceves. I can't offer anything at all to help you. But do check out another forum. I don't know about the RNY forum but the VSG one is really friendly.
The 2 names I see all the time are Dr. Alvares, and Dr. Aceves. I can't offer anything at all to help you. But do check out another forum. I don't know about the RNY forum but the VSG one is really friendly.
5'5" Age 63 HW 212 SW 200 Currently 8 pounds below goal
Jacque
Topic: RE: Approval
What does your insurance company require? You may need to know that. My BMI was too low, too. I had to gain enough weight to meet the minimum BMI. Plus I needed 2 have 2 co-morbidities. There was talk about needing a 3 year record of documented tried and failed weight loss but for some reason that neverr did come up.
So, what exactly does your insurance require? Have you talked to them yourself?
So, what exactly does your insurance require? Have you talked to them yourself?
5'5" Age 63 HW 212 SW 200 Currently 8 pounds below goal
Jacque
Topic: RE: Dr Joya
Hey
thanks for that guys.
I decided that im going to check into my coverage one more time and give it a go.
My mom actually had it done here and shes doing great shes about 4 years out and to be honest i dont see her take that many vitamins?
hhhmmmm i might have to get on her about that.
I guess it would just put me at ease if i could stay here in the us, ugh its such a big decision.
thanks for that guys.
I decided that im going to check into my coverage one more time and give it a go.
My mom actually had it done here and shes doing great shes about 4 years out and to be honest i dont see her take that many vitamins?
hhhmmmm i might have to get on her about that.
I guess it would just put me at ease if i could stay here in the us, ugh its such a big decision.
Topic: Approval
I have gone through everything with flying colors. The nurse sent all my stuff into insurance company, they denied it because my BMI was too low and they needed a 2 year record from my Medical Center. The nurse said she will appeal until the insurance comes through. The nurse faxed that in last Monday, my question is will this take along time?
Topic: RE: Dr Joya
I knew one person who had her surgery with Dr. Joya - she did fine with it. She had no coverage here either, but a good friend with the means to help her out paid for it. GREAT motivation for her to honor her tool and be successful.
HOWEVER - follow-up care has been an issue for her. So I would HIGHLY recommend that you make sure you have a PCP who is supportive of your having the surgery, and is willing and able to provide follow-up care. If you're looking at RNY especially, you need to take a ****tail of vitamin supplements daily for the rest of your life, and have labs done annually to be sure you're not deficient in any of them. At my 4 year, my PCP agreed to take over my bariatric follow-up. I have had an excellent relationship with him for many years, HE was the first to suggest WLS to me, and he has been my biggest cheerleader all along. So even tho I'm a PNC patient and can certainly see their bariatric team, I find it a lot easier to stick with my Doc, and combine my WLS follow-up care with my regular visits (I had Type 2 diabetes, so even tho he considers me essentially 'cured', I still see him twice a year.)
Whatever you decide, keep coming here for support and answers to the many questions you'll have. Even tho it's pretty quiet here these days, people are more than willing to share their experiences with you, cheer you on, and kick you in the butt when needed!
HOWEVER - follow-up care has been an issue for her. So I would HIGHLY recommend that you make sure you have a PCP who is supportive of your having the surgery, and is willing and able to provide follow-up care. If you're looking at RNY especially, you need to take a ****tail of vitamin supplements daily for the rest of your life, and have labs done annually to be sure you're not deficient in any of them. At my 4 year, my PCP agreed to take over my bariatric follow-up. I have had an excellent relationship with him for many years, HE was the first to suggest WLS to me, and he has been my biggest cheerleader all along. So even tho I'm a PNC patient and can certainly see their bariatric team, I find it a lot easier to stick with my Doc, and combine my WLS follow-up care with my regular visits (I had Type 2 diabetes, so even tho he considers me essentially 'cured', I still see him twice a year.)
Whatever you decide, keep coming here for support and answers to the many questions you'll have. Even tho it's pretty quiet here these days, people are more than willing to share their experiences with you, cheer you on, and kick you in the butt when needed!
Imperfect does not = unsuccessful
Topic: RE: Chatroom
My son suggested me trying another computer we have at home....and it did the trick. I'm finally able to get in this morning.
Topic: RE: Introducing Myself
Congrats on thie beginning of your journey....I look forward to your updates...This site is great to come to for support....Good Luck and keep us informed....
"Your body is the baggage you must carry through life. The more excess the baggage, the shorter the trip."
- Arnold H. Glasgow
- Arnold H. Glasgow
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