Needing HELP With the process and someone to talk to.....

Whats up guys, My name is Chris im 21 and live in waco tx...this is the second time attempting to get the gastic bypass...two years ago i wasnt ready.... i have been researching this thing for almost 3 years and have came to the conclusion that this is what i want to do.....im in the process of getting everything done that the insurance requires and is seems like alot for me to handle so i joined this site so far everyone has been a great help to me.....im just need more insite on this whole process.....im in school to be a paramedic and at this time i am not physically able to perform the duties required and this is my dream....i have been obese my whole life. I have made the choice to change that now......i have BCBS tx can anyone tell me more about the process of there requirements i just need more info......just remember without u guys i would be in this all alone.......thanks for all support and help!!!!! Christopher

Every insurance company is different. Every policy is different. Every doctor is different. I also have BCBX TX but they wouldn't cover my surgery, not because they don't, but because my employer has a provision written into the policy for our organization that prohibits any treatment for morbid obesity. I've seen on other boards though where other people who have BCBS TX have had no problems getting the company to cough it up. My suggestion would be for you to do a lot of research in to barriatric surgeons in your area on the internet. I don't know about Waco, but there are a ton in DFW and a ton in San Antonio. I would also look at getting your PCP involved in the decision making and referral process if you have one. In your picture you look like a pretty young buck and when I was your age I didn't have any need to go to the doctor, and thus didn't have a personal physician, but they can come in pretty handy in trying to navigate this process. Once you choose a barriatric doc  and have your first visit, they should have people hired on their staff that can help you with the heavy lifting on the insurance end. That's their job so let them at it. You can click on the doctor's name on my avatar to start researching. I would reccomend him as far as the surgery is concerned. My recovery and post op life has been a very small burden and I think that it's in no small part because he did a good job while he was in there. But he schedules and sees way to many people and it can **** you off pretty quickly when you're stuck in the waiting room forever. He's about 90 miles up the interstate from you. Good luck, and hang out here for any information you need to gather. There's a bunch of guys that have a hell of a lot more experience with this than I do. JF

Thanks for that information Well see my mom works for BCBS so i guess i got a lil head start i did finally choose my Surgeon and will call him SUCCESS... since ur insurance didnt pay for the surgery how did you get it done just wondering..... Chris

I borrowed $25,000 against my 401k. I'll be paying it back over the next 5 years. Or declaring it as income and getting the **** taxed out of me. One of the two.

Welcome to the locker room, Chris. There's a lot of excellent information here on the board and I would suggest you learn as much as you can about WLS and how dramatic your life will change.  It's all about how YOU will take advantage of a one year window to drop the excess weight and get healthy. More importantly, it's about how YOU will change your eating and exercise habits so you will remain healthy for the rest of your life. Become a student of nutritional eating and try to find a passion for some form of physical activity, for example weight lifting, hiking, running, cycling, swimming, etc.  You are extremely fortunate since you will be able to enjoy the benefits of becoming healthy for a great number of years given your young age. The single biggest regret most men, including myself, have regarding WLS is that we waited too long to get it done. We put up with all the negatives (physical and emotional) of being obese for way, way too many years.    Best of luck with your WLS journey. Boner

Glad you clicked the link here. Check out a few helpful pieces of info from the 'Insurance Forum' at-

Before You Begin 

Insurance - Private / Self Funded 

Avoiding Denials 

Medicare 

Insurance By State 

Insurance References  also, check out any helpful stuff at- http://www.weight-loss-surgery-insurance.com/authors.html Both have specific information to guide folks through the insurance And approval processes. WLS is a huge lifechange, And one that many wishes they had done years earlier. If insurance is out of the question Or if BCBS TX has an exclusion written into your policy, There are self-pay-financing options available. Some include- Patient Financing www.carecredit.com www.capitalonefinance.com www.healthready.com Hollar out if you have questions. The guys here are very willing to share what they know and what has worked for them. Best Wishes- Dx

Hey Chris, Greetings from South Carolina.  As you can see, I had my WLS about a month ago.  I  am extremely pleased with my decision.  In terms of insurance, I was in the same boat as you.  My insurance with the state of South Carolina did not cover anything associated with weight loss.  My saving grace was that my wife (she had her surgery about 2 weeks ago) is a nurse at a local hospital in Columbia.  Her insurance does cover WLS.  Because of our medical history, we are covered by both insurances.  Because of that HER insurance is paying for both her and my WLS.  As you will soon find out, you'll have a lot of hoops to jump through before surgery.  Don't get discouraged, but trudge on through.  Part of the reason is they don't want any surprises and they want to know you are committed to this.  As you can tell, a lot of us call this a journey.  And it is.  You are just beginning and we are here to help.  If you have ANY questions, feel free to ask them here.  There's plenty of guys here that are more than willing to help.  GOOD LUCK!

Chris, Glad to see you found the Men's Forum and have started to post..  The guys on here are great and they have already given you some great advice.  Having WLS is a great way to get your life back.  But it is a tool and you must comit yourself to a healthier way of living to get the most out of it.  Research the site, study the doctors and do all you can to inform yourself.  Ask any questions you might have.  The guys here are very knowledgeable and will always give a straight and honest answer.  One of the best ways to stay on track and inform yourself is visiting this site quite often.  It really helps to read about other's success, hardships and even failures.  You will find people who were once so big they had to stop and rest every 10ft when walking who can now run 5k, 10k or even marathons.  You will find people who now can cycle all day long, lift weights and look like bodybuilders, and those who walk long distances.  You will also find a lot of guys *****ally care about each other here in the Men's Forum.  And friendship is the best source of all. 

Hey Chris, I'm five months out and the "big changes" for me aren't about the surgery, they are about dealing with all the energy I have and making healthy choices every day.  The surgery, for me, was the easy part.  I was in and out in two days with an open RNY and had no problems.  It took me 8-10 months to get insurance approval, but I simply persisted and did every stupid little thing they asked.   I have been obese all my life, too.  I'm down 125 pounds and starting to look like my idea of normal.  I've got 60-70 pounds to go.  The change is profound.  Sometimes I feel so different inside my own skin that I don't feel like me anymore.  I hang out here on these boards, attend the support groups at my hospital and go to Overeaters Anonymous every week.  I would have never thought I would do these things before, but now I find they really get me "up" and ready for another week.  When I considered these things prior to surgery I thought they would be a real drag.  I'm surprised that I actually look forward to them now. I exercise, not enough but every day some.  I eat three meals a day and don't snack (works for me).  I follow my doctors advice to the letter and have never dumped, never puked and never been sick.  That's also lucky, but following medical advice sure helps. In the long run even the insurance nightmare will be small stuff.  If all else fails, negotiate a rate with the doctors and hospitals.  If you pay out of pocket they will drastically reduce their fees.  I have read on these boards where people have had succes with surgeries in Mexico, but I don't know a lot about that. Glad you are here, Chris! CB 

Christopher - sent you a PM.