41 year old fat guy from Wisconsin
Be proactive and check in with them repeatedly once things are submitted. Document everything and make sure you have copies of your information. And get your primary care provider involved as well so they can support the decision. Also, check with your insurance company to know exactly what they will require. Some require you to do a pre-op diet, but only some of those require actual weight loss. Know what they require and make sure you do whatever it is. The approval part is a pain, but keeping on top of it does help.
Every dinner needs a side dish, on a slightly smaller plate. - Book of Mormon (The Musical)
Starting weight: 354 Surgery weight: 322 Current weight: 183
Thanks for a quick feedback. I do have a copy of my insurance company criteria so working off of that. Seems like I'm stuc****il I can complete the 6 month weight loss supervised.....in the mean time, I did send out almost 30 requests for medical info to be sent to my bariatric center....every person, clinic, or hospital Ive been to in the past 10 years I requested ALL records be sent. I also scheduled my psych eval and dietitian. I even contacted Adkins and asked for a copy of my invoice that I ordered food from there a couple of years back...just to prove I tried Adkins. I think I have a really good start...maybe I'm just getting anxious wanting this done. I have diabetes, sleep apnea, hypertension, high cholesterol.....yup pretty much every fat guy disease I have. I work for the State of Wisconsin and now paying for a very expensive insurance plan WSP State Standard Plan, that covers this procedure.....so hoping this goes through smoothly so end of the year can switch back to the regular HMO insurance I have had.
The posts in this forum are great.....really gives me alot of hope. Thanks!!
The posts in this forum are great.....really gives me alot of hope. Thanks!!
Hi,
My doctor wrote a letter on letter head with my visit notes stating the importance of the surgery. And the nurse coordinator said the thing that really got mine approved was my phyc evaluation. She said the report was VERY thorough and the evaluator stated in my report that I seemed to be very knowledgeable about the surgery/procedure and what lifestyle changes it involved. The funny thing is, I just went with the closest evaluator in my town, but apparently he dealt with a lot of pre-op bariatric patients. Mine was approved within 2 days.
My doctor wrote a letter on letter head with my visit notes stating the importance of the surgery. And the nurse coordinator said the thing that really got mine approved was my phyc evaluation. She said the report was VERY thorough and the evaluator stated in my report that I seemed to be very knowledgeable about the surgery/procedure and what lifestyle changes it involved. The funny thing is, I just went with the closest evaluator in my town, but apparently he dealt with a lot of pre-op bariatric patients. Mine was approved within 2 days.
I was a little confused with your comments about your insurance. Barring an open enrollment period during 2012, I assume that you want to get back to the old HMO as of 01-01-12. I worked for the Fed Govt and have my choice of about 30 plans available in my area (some national & some regional). I find myself reading several brochures every year to determine which plan to go with. I do pay about 25% of the cost of the group ins. I think I've been in 4 different plans over the past 30 years mostly due to costs. The Fed gov't has a provision that a new insurer can not refuse you coverage based on a prior condition.
I weighed about 575 when I had my RNY and could barely walk from one room to the next even with the help of a cane. Plus, I have mental problems and my shrink wrote a long detailed report listing that as a co-morbidity even though the illness is genetic.
I weighed about 575 when I had my RNY and could barely walk from one room to the next even with the help of a cane. Plus, I have mental problems and my shrink wrote a long detailed report listing that as a co-morbidity even though the illness is genetic.
I went from paying $68/month for the family plan HMO, which does NOT cover bariatrics to $480/month for the Alternative plan that DOES cover the procedure. I don't think I will have a problem getting the procedure approved....I'm just trying to get all my ducks in a row so to speak. My primary doctor and endocrinologist are supportive of me getting this surgery. I keep researching any problems people may have had with getting their INS approval so I can take care of that before it becomes a problem. I do have to do a 6 month supervised weight loss....my doctors are taking care of that, but for added "insurance" I joined weigh****chers and my 6 months will be up end of April. SO hopefully can have the procedure completed and in 2012 go back to the cheap HMO insurance that has always been great, except for not covering Bariatrics!
How have you done after RNY?? I'm at 325lbs / 5'11 and feel miserable. I'm sure at 575 it was a challenging time in your life! Hope the surgery was successful!
How have you done after RNY?? I'm at 325lbs / 5'11 and feel miserable. I'm sure at 575 it was a challenging time in your life! Hope the surgery was successful!
I'm down to 337. Any weight I lose now will be primarily by staying on a restricted calorie food plan (diet). I'm a food addict and have difficulty with sugar, refined white flour, and junk food. I know what foods turn me on but I have trouble avoiding them. Some people say that food addiction is different from other addictions since you have to eat. But, you can avoid the addictive foods. Having said that, I don't understand much about digestion and the production of insulin. I do know that it's not as simplistic as I make it sound.
I'm manic-depressive like several other people in my father's family. All of the family members who are manic-depressive are unable to work. We also have several family members who suffer from depression. My brother is one of those. I take meds to stabilize my moods plus a anti-depressant. I'm usually taking the same type of anti-depressant as he is and in the same dosage. The depression gets worse with age and requires changes in medication. Many people who have either of these conditions have weight problems in part because most of the meds increase appetite. I'm not using that as an excuse.
There was a complication with my RNY and I was confined to a hospital bed at home for about 4 months following my surgery. I've never been able to do the physical exercises I should do. I do walk with a cane or rollator ( a walker with a built-in seat). I have to be careful when I walk with just a cane. If I turn my head too quickly as when someone calls me, I tend to get off balance, stumble, and I used to fall a few times a year. Since I am aware of that problem, I'll stop walking, steady myself, and then look to see who is calling me. I haven't fallen in a couple of years now but I am always cautious.
I knew when I had my RNY that my goal weight was going to be what most people's starting weight was. That was fine with me because I faced poorer health and death if I didn't have it.
I'm manic-depressive like several other people in my father's family. All of the family members who are manic-depressive are unable to work. We also have several family members who suffer from depression. My brother is one of those. I take meds to stabilize my moods plus a anti-depressant. I'm usually taking the same type of anti-depressant as he is and in the same dosage. The depression gets worse with age and requires changes in medication. Many people who have either of these conditions have weight problems in part because most of the meds increase appetite. I'm not using that as an excuse.
There was a complication with my RNY and I was confined to a hospital bed at home for about 4 months following my surgery. I've never been able to do the physical exercises I should do. I do walk with a cane or rollator ( a walker with a built-in seat). I have to be careful when I walk with just a cane. If I turn my head too quickly as when someone calls me, I tend to get off balance, stumble, and I used to fall a few times a year. Since I am aware of that problem, I'll stop walking, steady myself, and then look to see who is calling me. I haven't fallen in a couple of years now but I am always cautious.
I knew when I had my RNY that my goal weight was going to be what most people's starting weight was. That was fine with me because I faced poorer health and death if I didn't have it.
Most Active
Recent Topics
