Waiting, waiting, waiting...

 I decided a few months ago that bariatric surgery was something I wanted to do, but I guess I didn't know what all had to be done before I could really get started. I went to a seminar and submitted all of my paper work to the program and then scheduled my appointment with the surgeon. Now that's all done, but I still have a bunch of other stuff to do before my date can even be set. 

I'm seeing a psychologist for the psych eval and she's thinking that will take another two weeks. 

It took me two weeks to get an appointment with the dietician and I have to work with her for three more months. 

I know that in the end three months will feel like nothing, but right now it just feels like everyday I find out about another thing my insurance company will need before the claim can be processed. 

It will be November by the time it will be submitted and even then I could be denied. 

Right now it all has me frusterated, overwelmed, and a little down in the dumps. Is there any advide anyone can give me to help see the brighter side of things? Or information that could help me go through things easier? 

Also, I have BCBS federal and was wondering if anyone here had been approved by them for the DS? I've heard that since it's a newer surgery it is sometimes only partcially covered. 

I have Anthem BCBS. Mine is covered totally.  There are a lot of hoops to jump through for sure! It is frustrating. But just keep chipping away at it and before you know it, you'll be approved. 

As a side note, on my plan, they do not require a 6 month diet or anything, just two years worth of weights, history and physical and a 'blue distinction' facility.

I totally understand how you feel! The insurance hoops are such a pain in the a**! My insurance requires 6 months of a medically supervised diet, with weekly visits to WW meetings and 4 visits to my PCP. It's a lot of money and time that I feel is wasted. But, there is no way around it...so I just keep on chugging. The only good thing about it is that is has given me time to do as much research as possible about the DS.

The best piece of advice I can give you is to either go to your insurance's website or call them and ask for a list of their bariatric surgery guidelines. That is actually where I started. My insurance has the requirements nicely mapped out, so I know exactly what has to be done in order to get approved and I just follow that list. It also listed all the types of surgery they cover. If you get this list you won't have anymore surprises or setbacks. Good Luck!!!

I am waiting to hear.... any day now....

 Greetings EllieBean, 

I empathize with your situation. Back in January I too was put out when I learned how many hurdles I would have to jump in order to seek approval for the DS from BCBS of NJ. My surgeon required that I see a pulmonologist, psychologist and nutritionist. My insurance dictated the 3 month GP supervised weight loss program. 

Today I am so grateful for having jumped through these hurdles. For years I had been told that I was infertile due to my excessive weight. To establish co-morbidities for the insurance company, I went to a new OB-GYN to have current documentation regarding my infertility. This new doctor sent me for tests that my old doctor had not, and we discovered two large cysts on my ovaries. These have since been removed, and my surgeon is very optimistic that my chances for becoming pregnant post DS will greatly increase! 

I have also been placed on a CPAP machine to aid in breathing at night, as I suffer with sleep apnea. I was not aware of this fact previously. Now, I cannot imagine sleeping without the machine. I sleep deeper, i feel more rested, and I have gained so much daylight! I no longer crash on the weekends and sleep until 11am. 

There is so much to learn. I lurked on boards, did searches and started working with the necessary doctors to improve my health (I'm anemic,HGB @ 6 post cyst removal.) I feel as though these six months have brought me to a place where I have had ample time to prepare myself for such a life altering procedure. 

So perhaps you can look for the silver lining, and spend this time getting yourself ready mentally, physically and when your day arrives, you'll be that much more prepared for this life changing experience! 

Wishing you all the best. 

Thanks so much for all the feed back. I know that all of my frustrations will come with great rewards, all in good time.

I'm also glad to hear good things about BCBS! I live in Kansas and my local BCBS sucks and doesn't cover anything at all so I really lucked out that my step-mother had federal insurance.

I double and triple checked the guidelines so there shouldn't be any more surprises. My requirements are a nutritional eval, a psych eval, weight history, and three months of doctor or nutritionist oversight. I knew about most of those things in advance, but I had already been in a doctor supervised weight loss program for over three months and thought I had that covered, but apparently it has to be directly before the surgery pretty much. That was the biggest bummer because at the beginning of the year my out of pocket stuff resets and I have to start paying copays for every visit. At the moment everything is at no cost to myself.

Thanks again everyone!

I don't know if it will help but I also had to have three months of visits to the PCP, NUT, and Psych. It just so happened that my 1st visit for all three was towards towards the end of the 1st month. I immed. scheduled my 2nd and 3rd apts. so that I wouldn't have to wait for openings.

I actually ended up using less than 2 months as my first visits were the end of June, the 2nd in mid-july, and my third and final visits are scheduled for next week (first week of the month). By scheduling this way and doing all the extras (i.e. pulmonary, EKG, EGD, labs, etc..) right away in July, I will be submitted for insurance at the end of next week or early the following week. With a little creative scheduling, you can be through with pre-ops before you know it.

Good luck!

I am in a similar boat right now with my DH waiting.  We have BCBS and they will deny the DS if your BMI is not over 50.  But, most people win on appeal so be prepared to wait a little more just in case.  Other than that everything you are going thru is the norm.

Good luck!