Guest guest Posted May 21, 1984 Report Share Posted May 21, 1984 what kind of bcbs do you have and do they have a weight loss excution? sometimes the wording is such that all wt loss treatment is excluded but surgery for the diagnosed treatment of morbid obewsity is covered. carrie MoShel30@... wrote: > From: MoShel30@... > > Roxanne, > Thanks for the encouragement about the insurance. My BCBS plan has been > excellent about everything so far..... but what concerns me is that they > would not pay for a thyroid profile that my doctor ordered because he put my > diagnosis as obesity and that was only $138.00! Therefore, I am a little > nervous about what they are going to say but worry won't get me anywhere, > right? > > I will be thinking about you on June 15!! Best of luck and my prayers are > with you! Let me know how it goes! > > > > ------------------------------------------------------------------------ > ONElist: where real people with real interests get connected. > http://www.onelist.com > Join a new list today! > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1984 Report Share Posted May 21, 1984 think of all the money you will save on your grocery bill or like me my burger king bill carrie MoShel30@... wrote: > From: MoShel30@... > > Roxanne, > That is great that he was in your network! That is also a concern of mine > with him being out of state because normally my insurance will convert to > 80/20 for anyone outside of my net work! I hope I do not have to pay the 20% > because it will be tough on me but if it means changing my life forever then > I will find a way!! > > I have had this surgery on my mind so much that I even dream about it! In > one dream though I dreamed I got on the scales and had lost 10 lb. and was so > excited! Only to have the nurse come back and tell me that their scales were > 9 1/2 lb. off so I had actually only lost 1/2 lb! What a dream! I can't > even seem to lose weight and keep it off in a dream!! Ha! > > ------------------------------------------------------------------------ > ONElist: where the world talks! > http://www.onelist.com > Join a new list today. > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1984 Report Share Posted May 21, 1984 I haven t been denied yet but I know I will be. Why would they not pay for a thyroid panel if there were no wt exclution? carrie MoShel30@... wrote: > From: MoShel30@... > > , > I have BCBS of AL Preferred Care. To my knowledge there is not an exclusion > but when I talked to the human resources representative ( at husbands work), > she said what they would probably try to do is say that it is for " cosmetic > reasons " and will not approve it. I told her that was absolutely stupid! > Obesity is not " cosmetic " . Yes, it does make a difference in your looks and > how you feel about yourself definitely but come on!!! Let's be real. There > is a whole lot more to being obese than your looks! Everyone wants to judge > on that outward appearance! I told her that this is not something I have > just decided to do. I have been considering some type of wls for over two > years now. I do not necessarily WANT to have surgery, it was only as a last > resort. I have tried everything else without success. My looks are way > beyond the point, the point is MY HEALTH! I am 30 years old and already I > can look back and see so much that I have missed because of my obesity! What > about quality of life?! What about living without shortness of breath, joint > pain, reflux, gallbladder disease, diabetes, etc.? I want to live to see my > kids grow up! In the meantime though, I would like to be able to enjoy > playing with my kids and participating in their lives. Do they honestly > think people like to have surgery when it is not medically necessary? I > suppose there are a few out there who do but I do not think it is the > majority! > > Okay, I am over it now, just had to let off some steam! Thanks for > listening! I don't suppose I should get so worked up over it as I have not > been denied yet...... but I see so many people who have been denied and it > makes me angry to know that there is a procedure that can save a life in more > ways than one yet insurance does not want to pay for it as to them it is > " cosmetic " . They obviously don't have many obese people working for them. > > ------------------------------------------------------------------------ > Campaign 2000 is here! > http://www.onelist.com > Discuss your thoughts; get informed at ONElist. See our homepage. > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 22, 1984 Report Share Posted May 22, 1984 No My husband is from San Dieago CA and I was born and raised in siskiyou co. never been very far for me but Tim was in the a navy before I met him looking forward to going to see N. Carolina sometime soon I hope I am gettin to feel so crappy I feel like I should call the make a wish foundation soon. carrie35 married 2 rotten boys weed,ca bmi50 paige windahl wrote: > > > Candy, Hey have you or your hubby ever lived in ND?????? I grew with a buddy > named Tim O'Toole Paige > > > > >Reply-To: MiniGastricBypassonelist > >To: MiniGastricBypassonelist > >Subject: Re: I'm new to this! > >Date: Mon, 21 May 1984 09:21:07 -0700 > > > > > > > >think of all the money you will save on your grocery bill or like me my > >burger > >king bill > >carrie > > > >MoShel30@... wrote: > > > > > From: MoShel30@... > > > > > > Roxanne, > > > That is great that he was in your network! That is also a concern of > >mine > > > with him being out of state because normally my insurance will convert > >to > > > 80/20 for anyone outside of my net work! I hope I do not have to pay > >the 20% > > > because it will be tough on me but if it means changing my life forever > >then > > > I will find a way!! > > > > > > I have had this surgery on my mind so much that I even dream about it! > >In > > > one dream though I dreamed I got on the scales and had lost 10 lb. and > >was so > > > excited! Only to have the nurse come back and tell me that their scales > >were > > > 9 1/2 lb. off so I had actually only lost 1/2 lb! What a dream! I > >can't > > > even seem to lose weight and keep it off in a dream!! Ha! > > > > > > ------------------------------------------------------------------------ > > > ONElist: where the world talks! > > > http://www.onelist.com > > > Join a new list today. > > > ------------------------------------------------------------------------ > > > This message is from the Mini-Gastric Bypass List at Onelist.com > > > > > > > > > >------------------------------------------------------------------------ > >Where do some of the Internet's largest email lists reside? > >http://www.onelist.com > >At ONElist - the most scalable and reliable service on the Internet. > >------------------------------------------------------------------------ > >This message is from the Mini-Gastric Bypass List at Onelist.com > > _______________________________________________________________ > Get Free Email and Do More On The Web. Visit http://www.msn.com > > ------------------------------------------------------------------------ > Are you hogging all the fun? > http://www.onelist.com > Friends tell friends about ONElist! > ------------------------------------------------------------------------ > This message is from the Mini-Gastric Bypass List at Onelist.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 , Hi I am in alabama also, although I am not having the mini I love the people on the list so I hang out with them. I am going to Nashville to have mine done at centennial hospital. I have BC/BS and he says they are pretty good at approving it! I live in Union Grove.. about 15 minutes from Huntsville! if ever you need to talk just e mail or call # . welcome to the greatest support list there is!! karen aka kode Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Hi , I have BC & BS and was approved in under a week, actually I think it was 3 days! I do know that each BC & BS has different plans, mine is Empire BC & BS. Hopefully your approval will go as smoothly as mine. My Surgery date is scheduled for June15. Good luck with your insurance!! Roxanne Florida Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Roxanne, Thanks for the encouragement about the insurance. My BCBS plan has been excellent about everything so far..... but what concerns me is that they would not pay for a thyroid profile that my doctor ordered because he put my diagnosis as obesity and that was only $138.00! Therefore, I am a little nervous about what they are going to say but worry won't get me anywhere, right? I will be thinking about you on June 15!! Best of luck and my prayers are with you! Let me know how it goes! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Roxanne, Thanks for the encouragement about the insurance. My BCBS plan has been excellent about everything so far..... but what concerns me is that they would not pay for a thyroid profile that my doctor ordered because he put my diagnosis as obesity and that was only $138.00! Therefore, I am a little nervous about what they are going to say but worry won't get me anywhere, right? I will be thinking about you on June 15!! Best of luck and my prayers are with you! Let me know how it goes! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Hi ! Great to hear from you! What exactly is the difference between the mini GB and the other? I have read and researched it but I am still not sure that I understand it! I hate to sound dumb but like I said, I am really at the beginning of this whole process! I know where Union Grove is. I live in Northport, AL, about 5 minutes from Tuscaloosa! Roll Tide! Good luck with your surgery! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Hi ! Great to hear from you! What exactly is the difference between the mini GB and the other? I have read and researched it but I am still not sure that I understand it! I hate to sound dumb but like I said, I am really at the beginning of this whole process! I know where Union Grove is. I live in Northport, AL, about 5 minutes from Tuscaloosa! Roll Tide! Good luck with your surgery! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Hi ! Great to hear from you! What exactly is the difference between the mini GB and the other? I have read and researched it but I am still not sure that I understand it! I hate to sound dumb but like I said, I am really at the beginning of this whole process! I know where Union Grove is. I live in Northport, AL, about 5 minutes from Tuscaloosa! Roll Tide! Good luck with your surgery! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 , I have to say that I am really impressed with all of the people on this list! This is really my first day of subscribing to the list and I am amazed at the support! It really brought tears to my eyes to know that there are so many people out there who are like me, have my same thoughts and feelings, and who really care! Sometimes with all of the bad things I see on the news, and after hearing cruel remarks towards my weight, etc. I tend to get desensitized. It is refreshing to see that there are caring people in this world. If I gain absolutely nothing else from this experience other than having the opportunity to talk to all of you, then I consider myself a lucky person! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Kode-- I lived in Huntsville in the early 70's just out of college. It was a great place. Katy Musolino Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 , Thanks, and good luck with your insurance co., another thing I was worried about was Dr. Rutledge being out of state, but they(BC & BS) called me and said that he will even be in my network! Thanks, and good luck to you Roxanne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Janet-- Yes, I lived in College Park for about 6 months right after Rick and I got married. He was from there and owned a business, which we sold and moved back to Durham, where we had met on the Rice Diet. That's our medically supervised weight loss program. I lost 150 lbs in about 6 months, but gained it all back and more over the next 5 years. And lost, and gained, and lost and gained...... Same old story. But not any more. I will definitely be by to see you in the hospital. Katy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 You'll need info concerning tyhe BCBS affiliate in Alabama. What they do is not the same as , say, BCBS of Michigan or BCBS of Illinois. From what I've read in this newsgroup. the Blues seem relatively reasonable, but that's not hard given the abysmal track record of most other carriers and plans. Dave from Michigan BCBS of Michigan SD 3/26/99 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Welcome . I hope everything goes smoothly for you with your insurance approval. I have BCBS of MD and they denied my first request but approved on my appeal letter. My criteria to meet was that I prove a 5 year failed diet history and have a physician's diagnoses of morbid obesity...neither was really difficult although I had to pull on the old memory for the diet history which wound up being a whopping 14 years and an 88lb gain (can't get much more failed than that, huh?). I also had to have a BCBS rep deem my wls as medically necessary. At 5'5 " and 300lbs, I would love to meet the rep who would decide differently :-) Each state is different but you may want to investigate it through your benefits guide. They should have the criteria listed for wls, and if not, you can always call them. Please be forewarned, insurance companies' customer service reps are usually anything BUT customer service oriented...best of luck. As for the difference regarding the Mini Gastric-Bypass vs a regular Gastric-Bypass, the mini simply refers to minimally invasive...meaning it is done laparoscopically. Only four small incisions are made and special equipment (including a camera) are inserted into the body where Dr. R. can monitor the surgery via video equipment. He has an extremely informative site at http://www.clos.net if you'd like to learn more. By performing this surgery laparoscopically, Dr. Rutledge has significantly decreased the recuperating time for his patients. Most are out of the hospital after two days and back to work in two weeks because there is no large incision made. When the gastric bypass is performed open, there is a large (12-24 inch) incision made and the patient will spend weeks recuperating. Less pain and less expense...not too shabby!! A Dr. who actually cares about his patients best interests...go figure! Dr. Rutledge is highly appreciated, adored, and respected among his patients. I doubt you will find a more loyal following than those here at this list. They are also the most supportive, open, and caring group of people anywhere. I sense you've already found that out. Welcome again, we're glad you're here. A friend from land, Janet age: 35 bmi: 50 status: approved; surgery date 7/19/99 family: married 15 years with 4 children (2 girls & 2 boys) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 WELCOME, and don't worry if you get denied , you can fight and fight and fight. God bless Kathy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 1999 Report Share Posted May 20, 1999 Katy, wasn't that you who told me awhile back that you had lived in land too? My goodness...you got around. Were you military? Do you think you will be able to come visit me and Vicki M. on July 19 when we have our surgery? I'd really like to meet you in person. A friend from land, Janet age: 35 bmi: 50 status: approved; surgery date 7/19/99 family: married 15 years with 4 children (2 girls & 2 boys) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1999 Report Share Posted May 21, 1999 Roxanne, That is great that he was in your network! That is also a concern of mine with him being out of state because normally my insurance will convert to 80/20 for anyone outside of my net work! I hope I do not have to pay the 20% because it will be tough on me but if it means changing my life forever then I will find a way!! I have had this surgery on my mind so much that I even dream about it! In one dream though I dreamed I got on the scales and had lost 10 lb. and was so excited! Only to have the nurse come back and tell me that their scales were 9 1/2 lb. off so I had actually only lost 1/2 lb! What a dream! I can't even seem to lose weight and keep it off in a dream!! Ha! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1999 Report Share Posted May 21, 1999 Dave, Thanks for the info on BCBS of AL. I see that your surgery date was 3/26. and I am curious as to how things are going for you? I am very nervous and I don't even know if I am approved yet! All I know, is that I have tried everything else over a 14 year period and WLS seems to be my last hope. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1999 Report Share Posted May 21, 1999 , I have BCBS of AL Preferred Care. To my knowledge there is not an exclusion but when I talked to the human resources representative ( at husbands work), she said what they would probably try to do is say that it is for " cosmetic reasons " and will not approve it. I told her that was absolutely stupid! Obesity is not " cosmetic " . Yes, it does make a difference in your looks and how you feel about yourself definitely but come on!!! Let's be real. There is a whole lot more to being obese than your looks! Everyone wants to judge on that outward appearance! I told her that this is not something I have just decided to do. I have been considering some type of wls for over two years now. I do not necessarily WANT to have surgery, it was only as a last resort. I have tried everything else without success. My looks are way beyond the point, the point is MY HEALTH! I am 30 years old and already I can look back and see so much that I have missed because of my obesity! What about quality of life?! What about living without shortness of breath, joint pain, reflux, gallbladder disease, diabetes, etc.? I want to live to see my kids grow up! In the meantime though, I would like to be able to enjoy playing with my kids and participating in their lives. Do they honestly think people like to have surgery when it is not medically necessary? I suppose there are a few out there who do but I do not think it is the majority! Okay, I am over it now, just had to let off some steam! Thanks for listening! I don't suppose I should get so worked up over it as I have not been denied yet...... but I see so many people who have been denied and it makes me angry to know that there is a procedure that can save a life in more ways than one yet insurance does not want to pay for it as to them it is " cosmetic " . They obviously don't have many obese people working for them. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1999 Report Share Posted May 21, 1999 , LOL, you are so right but I will save money on my pizza bill!! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1999 Report Share Posted May 21, 1999 , I was told that had my thyroid profile came back abnormal then they would have paid for it but since it was completely normal and my diagnosis was obesity, therefore it was considered routine, and they would not pay for it. It makes absolutely no sense to me but...... From what I hear from most people though is that BCBS has been fairly reasonable about paying for this surgery. If not, I am willing to fight. I just hope that I do not have to. I am praying about it. Don't give up hope and you have to keep in mind that BCBS policies vary depending on your state and policy type. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 1999 Report Share Posted May 21, 1999 I also am concerned about the total out of pocket costs needed upfront, but I guess if I am approved they will clue me in? Re: I'm new to this! From: MoShel30@... Roxanne, That is great that he was in your network! That is also a concern of mine with him being out of state because normally my insurance will convert to 80/20 for anyone outside of my net work! I hope I do not have to pay the 20% because it will be tough on me but if it means changing my life forever then I will find a way!! I have had this surgery on my mind so much that I even dream about it! In one dream though I dreamed I got on the scales and had lost 10 lb. and was so excited! Only to have the nurse come back and tell me that their scales were 9 1/2 lb. off so I had actually only lost 1/2 lb! What a dream! I can't even seem to lose weight and keep it off in a dream!! Ha! ------------------------------------------------------------------------ ONElist: where the world talks! http://www.onelist.com Join a new list today. ------------------------------------------------------------------------ This message is from the Mini-Gastric Bypass List at Onelist.com Quote Link to comment Share on other sites More sharing options...
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