Hello, new here

Hello. I am new here and just embarking on this WLS journey. I dont even know what to ask or what can happen. I am attending a seminar tomorrow night at Saint Elizabeth in Lincoln to learn what can be done. Does Insurance companies have a hard time approving this; I dont think I have alot of Co-morbidities. I know I am pre diabetic. I have had a joint replacement in one knee and the other one is cracking. I have snooring problems. I know I stuggle with depression. Can someone help me answer questions, etc. Thanks and God Bless Kym

Hi Kym, welcome to the group. Your first phone call should be to your insurance company. Ask them if they cover weight loss surgery and what criteria you need to get approved for surgery. The bariatric coordinator at St. Elizabeth is Shelly Holman. She can also help you. Let us know how you are doing. Mona

Mona: Thanks I just got off the phone with my insurance Co. Midlands Choice/Principal. They listed all the criteria and said that they approve both the lap band and RNY. She said that the main thing will be the documented prior weight loss failures. Of 12 months. I have had several docs. Do I call them and have them send the info to my current fam doc or wait for the St. E's docs to do it? Thanks

Hi Kym, you need to get all the documentation from the last 3-4 years from all the doctors and send it to the surgeon's office. The insurance specialist at the office will also give you a list of documentation you will need. I am so happy that your insurance will pay for it. Good luck.  Mona

Hello- The first thing I want to ask is what is your BMI ?? IBody Mass Index. If you do not know what this is, then look around on this site for a BMI calculator. Put in the info and find out. Insuarance companies have to have this . Most insurance companies want the BMI above 40 if you have no co-morbidities. Your insurance company will tell you what they require for WLS. Keep us informed. Blessings to you, Chris C

Chris Hello. My BMI is 42. I have a few co morbidities but not like others. 

Welcome Kym.. You will learn so much after your meeting tomorrow night .A lot of questions will be answered. People aren't jumping in with answers because every doctor and insurance company are differant. What works for one person doesn't always work for another. It does help if you have you PCP on your side. I had a letter from mine and from my Rhumatalogist. Some insurance companies make you go  on a supervised 6 month diet.. so many hoops to jump through. Call your personal insurance company and see what they need. At your meeting tomorrow they may be able to tell you what experiences they have had with your carrier. What ever youhave to do, no matter how long it takes most will tell you it was worth the hassle and the wait. Hang in there,

Jean

I am so excited to learn things tomorrow night that I cant think. It just feels like there may finally be something to help me. And maybe this is it. I am so tired of being BIG. I just feel so tired and heavy. I had to have my gallbladder taken out in 1990, had kidney stones in 1998 and had a knee replacement in 2003. I have been on WW about 3-4 times, I tried the Medicaly supervised program HMR ( for about a week) it was so gross. And have tried low carb, low cal, low fat etc diets on my own. I just lose and gain the same weight over and over. It is just so hard to exercise with the excess weight on my knees.

WHich surgery did you have? Were you off of work long?  Thx Kym

Sorry it took me so long to reply. I had the RNY lap, I was back to work in 3 weeks. ( I have a part time sit down job) I had wanted tohave the band because I was crazy about the invasivness of RNY but my insurance (medicare)didnt do band. I am glad I had RNY now, they weright came off so quickly and I have a LIFE now..I know you are not happy about how long this journey may take, but as everyone has told you, jump in and get started..Best of luck to you.

Kym, I am five years out from my Lap RNY, and not a day goes by that I don't feel gratitude to the man upstairs and the two men in the O.R. My docs up in Scottsbluff gave me back my life.  I had not realized how much I had stopped participating.... I wrote a rather long (several pages) personal letter to go with whatever documentation the insurance company needed.  I needed intervention, I needed an answer to my prayer.  My body was a personal prison.  I was not what people saw, and believe me at 360 they saw a lot!  I have lost 200 pounds, and most of that was in a year.  When I had lost enough weight to try for my plastic surgery, had some pre-ops tests and during this screening they found Kidney Cancer.  So you see, WLS saved my life, twice.   Whenever I have the occasion to see Dr. Forney or Dr. Holloway, a big smile comes to my face, and I give them a big hug.  I don't have to hide anymore from living.  If you decide to have the surgery, whichever type, embrace it with your heart and soul.  Listen to the aftercare info and BE COMPLIANT.  Those who generally get into trouble do so because they  get creative with their own set of post surgical guidelines.  God Bless and good Luck with your insurance approval.  Betty