Group Health and asking for surgery

Hello All---- Been lurking for a while and now ready to ask a few ?????'s . I have group health alliant select and was recently diagnosed with possible sleep apnea and arthritis. I am awaiting approval from group health to do sleep study. Have been referred to a orthopedic specialist and have appt with them for my knee's. I really want to ask primary care doc about getting this surgery but not to sure how to go about it. I am 5'6 and weigh 270 and think i do qualify. Very weery on how to ask or bring up this wls. any help Appreciated with this and any others who had to got thru group health thank you )

I have GH, too, and am just now starting the process. My ob/gyn suggested the surgery and said they would pay based on my criteria. I have an appointment with my primary doctor next week. I'll let you know. Kathy

I have a friend with GH. He was told he must be on a six months supervised diet, before approving surgery. What I don't know is what happens then? If he loses will he not be approved? If he doesn't lose, will they say he didn't comply? Most of us can lose. The trick is keeping it off! Good Luck Deb in Kennewick

HELLO- AFTER FINDING OUT THE HOOPS THAT GROUP HEALTH MAKES YOU GO THROUGH FOR THE APPROVAL FOR THE SURGERY, A YEAR LATER, I CONVINCED MY HUSBAND TO SWITCH INSURANCE COVERAGE. WE WENT TO PPO, AND SO FAR I'VE ALREADY GOTTEN THE PROCESS STARTED, AND FROM WHAT I CAN TELL, THEY DON'T GIVE TOO MUCH TROUBLE TO PTS WHO WANT THE SURGERY. ANYWAY, I WAS TOLD BY AN ORTHO DR THAT THE WLS WOULD BE A GOOD THING FOR ME, AND HE WOULD HIGHLY RECOMMEND IT, HOWEVER MY FORMER PRIMARY DR INFORMED ME OF THE CRITERIA THAT IS REQUIRED BY GHC. YOU CAN ASK YOUR PRIMARY, BUT BE FOREWARNED, YOU MAY NOT LIKE WHAT YOU HEAR. I SAW THE 'NUTRIONIST' A TOTAL OF 1 TIME, AND WAS TOLD TO WATCH WHAT I EAT AND INCREASE MY EXERCISE...NOT MUCH MORE. GO TO THE GHC.ORG WEBSITE AND YOU CAN VIEW THE CRITERIA FOR THE SURGERY. IT WAS ON THE SITE LAST TIME I CHECKED. GOOD LUCK!!!!!

I just went to my PCP today. She thinks this is a good idea for me. I fit all the criteria. I have to gather my 6 month documentation for WW and Curves. Then she will submit to the board for approval. I have heard that can take months, plus you have to prepay for the annual follow-up program (approx. $1500). I will keep you posted.

I am in the pits today-- I feel so frustrated with it all and have not even started any process yet, just reading and informing myself etc. From what i have heard around work, (Marysville School District) none of our insurance options (HMO PPO ETC) will cover this wls. Some written clause they throw in. It eeeeeeeeerks me so bad. I pay out of pocket $523.00 a month for insurance for myself hubby and 2 kids. I basically work for insurance that is useless HA !!!!!!!!!! To top it off my knee arthritis is killing me to the point where i cannot sleep at night. Doc does not belive in pain medication for relief either. I work out 3x's a week and honestly limit my food intake to no more than 1200 calories a day. I want to SCREAM!!!!!!!!!!!!!!!! Fianlly got the pulmonary (sp) person to call my back about my referall guess they will get me in late July LOVELY!!!! So on top on knee and sleep apnea who the hell needs to sleep right? LOL Ok feeling better after that vent hopping off my pity party now---- thank you for listening to my chit HAHHAHA

Just remember, you do have the option at GHC to change your PCP if you're not happy with the one you currently have. Unfortunately, I know more about the ones down in the south end that I do the ones up north. Have you thought about switching over to Eastside...I mean Renton or even Kent? That is, if it's not too far for you to drive.

Kathy, Your PCP sounds much better than my former one did. I think that some of them are of course better than others. I was never really impressed with mine...ever. She was always making me feel as though I was infringing on her time, and I always felt rushed in my dealings with her. I hope all goes well with your journey...good luck!!!