I'm new here... I have some questions.

Hello all.  I'm Jamie.. I am new here.  I just wanted to introduce myself.. and I hope to become active in this forum.  I am in the beginning stages of my weight loss journey.  I am very excited! I have not yet had a date scheduled for my surgery as I am just now going through all the pre-requirements for submission to insurance. I have chosen CMC-Mercy in Charlotte as my hospital.  I had my required endoscopy on Monday. THAT was an adventure!    I have my sleep study & nutritionist visit this week.. and my Psych eval next week before they can officially submit me for approval from insurance.  I guess I really dont feel like this is going to happen until I have that DATE.

 I must say that I dont typically post on forums, so I dont know exactly how detailed or in depth I should go on here... but I guess I feel like I really needed a place to talk to people who are in the same situation I am in.  I have a couple of questions....

 Does anyone here know any information about insurance coverage for this procedure? I have BCBS NC State Employee Insurance.. which covers the surgery.. but when I started this whole thing, I was under the impression my insurance year rolled over in September. I was thinking I was in good shape because my deductible had already been met for the year and I was chipping away at my 20% co-insurance.  Turns out my insurance rolls over in July!  I am just about positive that there is no way I will be scheduled by then.  It'd be great!! ... but I am guessing very highly unlikely. 

I am wondering in everyones experience... what was the time between approval and the scheduled surgery date? Is there a long waiting list?


Also... a more technical insurance question.    I have something called Medical Bridge 3000 Insurance.  Does anyone know if this surgery is an eligible procedure for that program??

I am sorry for the rambling... I am just excited and anxious and I want to know all that I can.

Thank you for reading!

Hi and welcome. I am 5 months out from my RNY and feeling great. As for BCBS I also have this insurance and as long as you meet their criteria and choose a Center of Excellence the approval is easy, no documentation needed or wait period. The criteria is a BMI of over 40 or a BMI 35-39 with a comorbidity like high blood pressure, diabetes or sleep apnea.
Each surgeons office takes a different amount of time for the process, no guess would be accurate. I am not sure what the other policy is, sorry.
CONGRATULATIONS on starting your journey. All the Carolinians are more than friendly and helpful. Please feel free to ask any questions or contact me if you just need to vent.
Audra

Hi Jamie, 

Welcome to one of the nicest, most support board on OH. I know I'm a bit prejudiced, but I really do find that this is a very warm, supportive group. You will find a mix of newbies like yourself and those of us who have been on the road for a while. How much people share varies from person to person, but when it comes to WLS related issues, generally it's no holds barred so you can feel comfortable asking just about anything. Everyone has been very thoughtful and respectful in answering queries. 

I look forward to getting to know you as you make your way on this incredible, life changing journey. 

All the best,

I personally probably tell too much but in reality I read pretty much like an open book to those around me - so I tend to be the same on here.  It is truly a remarkable group of people on here. You'll get the answers to your questions - normally in a very speedy time. You'll find this group to be extrememly supportive and when you think you've screwed up your entire surgery (I think we all feel that at least once) you'll get the loving guidance that you need even if it's not what you wanted to hear.

Sorry that I can't answer teh insurance questions that you've got but there is a forum just for insurance topics so you may want to find that and repost there.

Good Luck!! Post often so we can get to know you.

- Iris

I also have NC State Health Plan. It does roll over in July, but the approval process is really short, like 2 weeks at the most. BUT the clincher is that everything has to be sent in for approval. If you get your surgeon's office working with you, explain your deadline, they might be more helpful in getting it through. The best thing about having WLS now is that next year you will have to have a BMI of 40 to qualify for 80/20. The year after that it's lower.

I'm not sure about the medical bridge, but I have the supplemental disability plan that the state offeres through Colonial and they covered my time off work. It doesn't hurt to check. Give them a call and see if your medical bridge will cover.

Good luck on your journey!!!