Has anyone had a RNY through Kaiser Permanente?

If so, what kind of hoops did you have to jump through first?  My husband is considering changing to Kaiser since they will cover bypass surgery but his union rep said something about it taking a year, so I am guessing that would mean some kind of pre-surgery stuff.  Since we can't change the insurance itself yet, I wondered what they generally do during that year and if I could have some of it done now through my current insurance instead of just sitting around and waiting.  Can anyone clue me in?  Thanks, and hope everyone had a Merry Christmas!
Colleen

Hi I have Kaiser Mid- Atlantic and I dont know if that makes any difference that it is Mid-Atlantic but I switched to Kaiser purposely for the surgery and I am now approved and awaiting a surgery date, the whole program took me about 6 or so months, first a basic weight loss class then 4 nutrition visits and 2 other Gastric Bypass classes (GB1 and GB2), during this 6 months I had to keep food diary and do a psych evaluation... and then u go for approval approval took about 2.5 weeks... I hope this helps.

I have Kaiser North California and just had my surgery on Dec 15 and started the program in June. They are very strict about reaching your weight loss pre op goal. It usually takes 4-6 months. If i had met my goal sooner i probably would have done it in 5 months but it took me 6. Cali program sounds same as Mid Atlantic. I had the same visits. My weight loss goal was 25 lbs but i have known others given larger goals like 60 lbs. It depends on your weight. The goal is to make your liver healthier since you lose weight there first and it makes the surgery less complicated. I ended up losing 35 pre op and had my surgery last week and have lost 22 lbs in 10 days. it's amazing! Just a tip, if you do switch.....once your reach goal and move to the next stage....make sure you stay at or under goal because if you dont' they won't even see you! it happened to me and my appts were 2 hours away. i was 3 lbs above my goal and they sent me away and i had to start over.

I had RNY through Kaiser Permanente.  I had to go through their Options Program, which consists of 20 weekly classes where you are expected to lose about 10% of your weight.  They are very strict about attending all the classes.  If you miss one, you must make it up.  At first I thought that the classes were going to be a bunch of nonsense.  However, they proved to be invaluable.  You get a lot of information regarding the different types of weight loss surgeries, you learn how to keep a food diary, and how to count protein.  During the program. you get all the lab tests and other medical tests required by the surgeons. The classes also prepare you psychologically for the surgery.  Upon completion of the Options program, I was immediately referred for surgery.  I had the option to have my surgery at UCLA Medical Center, Pacific Bariatic Medical Group in San Diego, California or at Kaiser Permanente.  I chose to have my surgery at Pacific Bariatric in San Diego.  The Options program made all the arrangements and sent all the necessary information to the surgeon.  I had my surgery about 3 weeks after receiving the referral.  Looking back, I am really glad that I went through the Options program because it has been a big part in my being successful in my journey.

So, would you all say it is approximately 6 months (depending on rate of wt loss during that time and classes) from the time you start the process until you actually have the surgery? 

Yes, the process takes approximately 6 months.  Other requirements that I did not mention are that you must quit smoking and have a sleep test done.  If it is found that you have sleep apnea, you must get a C-PAP machine and have used it at least 2 months prior to surgery.   Good luck on your journey.

CJ I have Kaiser, live in Cleveland Ohio, and I'm on month 4 of the 6 months needed b/4 surgery. After being referred by your PCP for the surgery, I was contacted by the surgeon's case manager who walked me through a phone interview, after that I received through the mail a list of things that I had to complete, b/4 having an appt. to meet with the surgeon. That included: echocardiogram, EKG, labs, stress test, nuclear treadmill stress test, another kind of echocardiogram, 6months of once a month visits with the dietician, 2 or more support group meetings, then another PCP follow-up  visit, labs again, lose 10% of your current body weight, then the NUT refers you back to the surgeon's case manager for a surgery date. I know this sounds insurmountable but it's really gone faster than I thought, plus you learn so much of the needed information. I'm not losing very fast, even though I'm following a diet, and exercising and doing four 1-hour sessions per week of Aquacise. Hopefully, I'll meet my goal by the end of March. Good luck...... 

Hi Colleen!  I'm in the "severe Obesity program"(which is the program you have to go through with KP) in Salem and I'm almost finished with the process,
 
They unfouruately are very Kaiser exclusive, meaning you have to complete most of the steps at KP. Just make sure if you have any medical conditions that you have them under control.
If you haven't had a sleep lab get one, and make sure you are up to date with anything that your age requires. (PAP, Mammogram, shots ect..) it will make the process go much faster.
they may accept if you take a nutrition class at a different hospital as long as it is comparable.
there is definitely more required Pre-Op education involved than with most other HMO's, to learn about the process I encourage you to visit the KP weight loss surgery support group- there are many of them. I go to KP Salem it's the third Thursday of every month and it's open to the public.  The usual process is actually usually 12-18 months. It could be less depending...but it usually isn't in Oregon.

The usual process is this:
-First your PCP must refer you to the "severe obesity program"
Then you will receive a packet that you fill out and send in.
Then they tell you if you are approved or not.(you may have to call them and ask them if they got it they never usually call them)

-go to the introduction class(usually co-pay)
 
-take the 5 week nutitrion class
start food journaling if you haven't already(it's required)and establish an exercise routine.

-group meeting with physical therapist and social worker(the social worker is the mental health)
 they discuss how surgery might affect relationships.

-two one hour appointments with the social worker and dietitian(usually on the same day)

-Blood tests, Labs

-meeting with surgeon

-meeting with surgeon, anesthesiologist and case manager (Mary Lou)

-group visit with dietitian & physical therapist to discus post op life

    -SURGERY!!!!

                        
You have to call Mary Lou after you complete each step.
also the 10% weight loss is no longer a requirement for surgery(in this region)
 but it looks good on your behalf if you do(also regularly getting weighed and recorded =AT= KP is beneficial)
If you have any other questions please don't hesitate to ask!

I am in Clackamas.  Do they offer the surgery in the Portland/Clackamas area or do I have to go to Salem? 

Oh, and also, do you know if you have to repeat the sleep study within a certain amount of time prior to surgery, if at all?  I had once several years ago and have severe sleep apnea and am on a CPAP religiously (can't wait to get rid of that) but is that something they only need once or does it need to be repeated? 
Thanks, everyone for all your help! 

They do offer it in Portland but the units are the same and I have to go to Portland for some of the classes.

I think you are good with your sleep study, they only do it to see -if- you need a CPAP( it has to do with breathing/anesthesia during surgery) and if it's already being treated I don't think you will neep a sleep study.

I hadn't had one so I had to get one(didn't have sleep apnea)

also the general requirements are a bmi over 40 with at least 2 "significant" comorbidites or a bmi over 50- and they go by your weight when you first get approved into the Severe Obesity Program
I have no comorbidites but I had a bmi over 50 when I started.