Insurance
OK, this is the fun part! However, unless you want to pay anywhere from $20,000 and up for your surgery all on your lonesome, it is a neccesary evil to fill out your insurance's paperwork exactly as they wish it to be filled out.
My insurance is Blue Cross/Blue Shield of GA PPO. Now BC/BS is doing away with covering weight loss surgery (or so the rumor goes), but I am lucky enough to still qualify because the company my husband works for has a contract with them that does not expire until next year. Plus I did get my paperwork in before the end of 2005. I'm not sure which one is the one that covered my butt, but whichever way, I'll take it. But don't give up just because you have BC/BS, your company may have an elongatd contract with them, or they may get so much backlash from this (legally) that they re-institute it. It never hurts to try.
Even if you don't have BC/BS, what I filled out will give you a general idea of what all you'll need to be armed with. You may need less or you may need more. (Oh a lot of this stuff I had to fill out for consideration for the surgery to begin with. They won't just do this surgery on anybody who want it. You have to prove it is needed!)
- A list of all diets you have attempted in the past 3 years along with weight loss and regain (some of these must be able to be validated by either a Dr. or a program coodinator such as Weight Watchers, Jenny Craig, or a gym program that you joined)
- A signed letter from your primary care physiscian saying you have his/her approval for this surgery.
- A signed letter from your primary care physician saying you are cleared for this surgery (I found out there is a difference between the 2, which cost me almost 2 months of waiting time! Urrrgh)
- A Dr.s (primary care or gastric surgeon) stating you have BMI of 40 or more (usually about 100 lbs overweight) OR BMI of 35 with one or more Co-morbidities (such as Type 2 diabetes, high blood pressure, heart problems, high cholesterol, joint problems, etc.)
- A test for sleep apnea
- A psychological exam (I'll tell y'all more about my experience with this)
- Blood tests, including a thyroid test (to rule out weight gain due to thyroid problems)
I am sure there were a couple of other things, too; but these were the biggies I remember. The weight & diet history are the really important thing - if you turn in a list of diets saying you tried to eat less, then you'll never get approved! You have to have some proof that you have attempted dieting. Anything that can show that you've attempted to lose weight - gym membership receipts, logs from gym trainers, receipts from medication purchases, copies of prescriptions for weight loss medication, any medical records that your Dr. can produce, etc. My primary care doc was so helpful, the office provided me with an entire copy of my past 3 years of medical records. I went through them and any time he and I discussed wieght, and weight loss measures, I highlighted that and my weight taken on that day and turned that in.
Just be sure you have ALL of the information together that your insurance company requires before you turn it in, or you will be rejected, and have to start over. It may seem like it taks forever to get the stuff together (believe me I know!), but from the people I've talked to who have had to appeal and turn paperwork in a 2nd time, it takes even longer. So don't get too rushed and antsy in the beginning and do it wrong!