I'm sooooo confused :'(

[hotmomaNtraining]

Hello all, I am very new here so if I am posting in the wrong spot or ask something that has already been asked to death plz forgive me. I have been overweight all my life and nothing has ever worked for me to get it off and keep it off. I have wanted ELSE for a long time but was always scared up until the end of last year. A very dear friend of mine that I had not seen in a while posted a pic of herself on fb. I was blown away, she had list so much weight and looked AMAZING. I asked her how she did it and she said she did the sleeve in April. Right then and there I knew that I had to stop being scared and put on my big girl panties and just do it. Being right at 400 lbs and 43 years old I know that I won't live.much longer. I am a single mom of 2 teen boys. My youngest plays football and this past season I was not able to go to any of his games which.killed me but I either felt so bad or was just plain to embarrassed about my huge size. At the homecoming game, the players are walked out by their parents/parents and introduced. My son was to ashamed of me and my size to let me walk him out so he asked his brother to do it. I was devastated. Since then my depression about my weight has gotten worse and so has my emotional eating. I had just given up and didn't really care anymore. Then when I seen my friend it was like I got a huge V8 smack up side my head and a little voice inside said " ok dummy, stop the pity party and make this happen" . I contacted my PCP and she agreed that WLS was the best choose. I have a BMI of 54, sleep Sonia, high cholesterol, and high sugar levels even thigh it doesn't require meds YET.
She set up blood work, sleep study, and.physical. I go for physical in 2 weeks and sleep study within the next 3 weeks. I have an appointment with the surfing on May 13th at 3 pm and the seminar that evening at 6. I have tried calling my insurance company and I get NOTHING from them. I do know they cover the sleeve surgery and everything but as far as what steps to take before hand I can't get anything from them. I have researched the sleeve and got an overload of all the good and bad and what to expect and so on but unless I can find.out what hoops I have to jump thru it almost all feels pointless. I would REALLY like to have all my rest or whatever done before I go to the appointment with the surfing so that maybe I don't have to wait 3 to 6 months or more to have it done. I'm working on giving up sodas and learning to way without drinking. Which is my biggest obstacle for after surgery. I just want to know what to do to speed up this.process to get my sleeve. I'm ready to have my life back and be the mom my kids deserve. If anyone has any insight or advice plz let me know. I welcome all the help I can get. Thanks :-)

[hotmomaNtraining]

Plz forgive all the typos... Posting from cell phone and auto correct SUX LOL.

[ximmia]

Welcome! I think your autocorrect got the better of some of your sentences lol I would talk to your surgeon's office and their insurance coordinator. They are the ones familiar with local insurances and will be the ones to let you know what you need, they will collect all the information and then they will submit it to your insurance.

I'm very similar to you. I had my surgery just shy of my 41st birthday and with a BMI of 54.(something). At my heaviest I was 374 pounds. For me it was a combination of bad genes, bad habits, and bad events from my childhood still haunting me. The sleeve as a tool helps me with how much food I eat and the rest of it is just hard work. I always say "it's not roses and ponies" and that's true but if you commit every day and follow the four keys: water, protein, exercise, attitude - you will see success.

[Momof3monsters]

My dr.'s office has people to deal with insurance. They did all the talking and then let me know what I had to do to get it done. I was very lucky i just had to have a letter explaining why I needed it done, and I think they had to ask my reg. dr aswell. I belive most dr.s work with their patients to help them with the "hoops". good luck I am only (almost) 6 weeks after surgery and have lost over 30lbs. it's hard but worth it! You will have ups and downs but stick with it!

[hotmomaNtraining]

Thanks ladies :-D. Yeah i freaking hate auto correct. Lol i think my brain works faster than my fingers sometimes. Lol so do u think i meed to call the surgons office again before my appointment and talk to the corrdinator or just wait? I just dont want to have to wsit till this time next year yo get it done and miss out on my oldest last year at home. I want to give him a year of wonderful memories that he can carry with him as he leaves my nest. I dont want it to be another year of feeling like he is my caretaker because im unable to do anything except use the bathroom and shower on my own and hide in the car when we go somewhere because i get to winded if i walk across the parking lot.or i have to sit down a hundred times to ease the paon in my back from just walking down two isles at walmart. They deserve better and so do I. Im more than willing to give it 150% and then some to make it workno matter how gsrd it gets at times, all i have to do is look in their faces and know its going to be worth it...... Congrats on ur surgery and weightloss. keep up the great work.

[amyswisher]

Welcome!! and good luck hon. I know how you feel. I am a widow with an 11 year old son. I am sick and tired of being sick and tired. I am not doing the ins route, but from what I've seen it can range from 3 mo to around a year to get approval. Average is 6 months. Every surgeon is different as is every insurance. Several require a 6 month Dr. monitored weight loss program plus other stuff. It just depends. I would wait til you saw your surgeon to ask about ins approval. If you don't get the info you want, then I'd call myself. Just don't get discouraged!! For some, the journey is long....but worth it. I would mentally prepare now just so you aren't disappointed. I personally decided to go a different path for my sleeve. I think a lot of the hoops are pointless...but, that is just my personal opinion.

Good luck to you!! Stay positive, it WILL happen for you!!

[trishmred]

The medical team doing your surgery will go to bat for you with the insurance company.

[hotmomaNtraining]

Do y'all think I need to go to a dietitian and for a psych evaluation on my own before my appointment with the surfing and the seminar or just wait and go thru theirs? I love almost 3 hours away from the surfing so I don't know if I could get those appointments all in the same day with them or if it would be better to do it here before hand.

[thinmeskreamin]

Good luck. Sounds like you have a good shot as long as your insurance offers that kind of coverage. For those it has become difficult to get approval or didn't want to wait, there's medical tourism. So there's always going to be options. Do as you have started and research. Be ready to change your lifestyle. Stay motivated, see you on the sleeved side.

[Kathysangels]

Most of the surgeons have a dietitian and a psychologist on their site. Even if you had it done privately they may still request you be evaluated by theirs with their own criteria. I also had to meet with their physician, and their surgeon beforehand. I had 20 gazillion (or so it seemed) tests done before the surgery. I started to have the work done last August and got the approval on Christmas Eve. I was sleeved on Feb 11, 2014.

Good luck, be patient and don't give up!!

[SethP]

You are getting the normal NON-SERVICE from your insurance company. You dont mention which oneyou have and many of them have websites where you can research to see if WLS is covered. Some insurance it is a case by case or like mines it is a NO GO policy. They do not cover WLS of any kind so I was left with the option of self-pay. With that said I started looking into cost. I could have done it down in Mexico for about 5k but opted to do it here in the states. IT costed me 15k and I was able to finance it and make payments. Doing here was not because of anything bad with going to Mexico, it was more of peace of mind of having family and surgeon close by IF i needed support after. My surgical team has been awesome and the after support is awesome. Some of us need to be pushed harder then others i guess. Godspeed on your Journey to a healthier you.

[hotmomaNtraining]

No Seth, my insurance pays for it but when i xall them i always get someone who sounds like they are reading a script with just standard answers. They don.t seem to know what all i have to do heck, they didnt even know which doctors in their network even done wls. I had to call diffrent docs and ask myself. I swear sometimes i feel like i am repeatedly hitting a brick wall but that goodness im hard headed and stubborn lol. I think once i go to the seminar and my first appointment with the surgon on may 13th i will have answers to almost all my questions. I just hate the feeling of not knowing anything and getting antsy wanting to get it going. I really think my OCD is in hyperdrive lol i just hope yall dont get tired of my craziness b4 hand...lol

[hotmomaNtraining]

Btw I have amerigroup of tennessee insurance

[Leanng]

Take a deep breath and be patient. Go and talk to the surgeon and all will fall into place. I know darn well how hard it is to wait, but I think you will find that your surgeon will have a good comprehensive program that will meet all your needs. I know that when I started it was going to be forever until the surgery, actually it was 3 months and 10 days from my first appointment until surgery day. That included the insurance approval. The doctors office took care of everything - including the discussion with the insurance company.
The sleeve was the best decision that I have ever made for myself. Take your time, there is a lot to learn and think about. I would offer the suggestion to read about how you will need to eat after the surgery and give it a try. I was able to lose 40 pounds prior to my surgery and I was ready to start the beginning of my new way of life.
Best of luck to you, it is going to happen for you. You will be so proud of yourself. This is a great place to learn and to come for support, it's also a great community of very caring people that understand exactly what you are going through.

[hotmomaNtraining]

Thank you so much. I know i have only been on this sute a little while but i can already tell thst the level of luv, support, and genuine care is amazing. I look forward to my journey to sleeve day and after with all u guys. God bless u all. Happy Easter :-)