The process is under way. Now that my insurance has decided to cover weight loss surgery, I have jumped right on board. I had to wait until our new plan year began April 1st.
Once April first rolled around, I was finally able to call and see what all I would need to do to get things rolling.
The first step was that I had to enroll in a Bariatric Resource Group. This entailed me calling them and answering a few common questions, i.e. height/weight/BMI and if I had any issues related to weight. I quickly answered those questions and was told that I met the basic requirements. The customer service representative then advised me that she would need to schedule a phone appt for me to discuss things more in depth. She told me they would schedule this call as it would take about 45 minutes.
Friday, April 5th I was on the phone for more like an hour with the nurse. She asked me questions about my health history, she took down the names and doses of all medications I currently take, we talked about my reason for wanting surgery and then we talked about the surgery itself. There is a great level of commitment on my part for this surgery. I have to be willing to commit to a liquid diet before and after the surgery. There will be certain things I may not be able to eat again. Diet Coke, which has been like a long time best friend will probably be no more. The nurse told me that I would be off work anywhere from 1-2 weeks.
At this point I am super excited. Its definitely the surgery I want to have. I want to be able to move easier, I want to feel better and I want to see my kids grow old. Several friends have had this surgery at different hospitals with different doctors. I had read about a certain doctor that I wanted to use, a friend had even used him. I was set.
My insurance requires that in order for me to have the surgery, I have to choose a facility that is recognized as a "Center of Excellence". Well friends, in Oklahoma that means you have, wait for it, 2 hospitals to choose from. TWO in the ENTIRE STATE! The COE hospitals are Norman Regional and Integris Baptist. Along with using a COE hospital they have specific surgeons for you to pick from. In my state that is 3. Yep, just 3 surgeons to pick from. I was bummed. The surgeon I had my heart on was not covered and I was not familiar with any of my three choices. I think the nurse must have picked up on my sense of confusion and quickly added, these surgeons we provide coverage to have to meet some pretty high standards. My insurance will not pay for just any surgeon.
So I have picked my choice and as it turns out, another friend had her surgery with this surgeon and she is very happy with her choice and she did great. I am relieve now and overall reminded that I am very grateful that my insurance is even covering it. Some friends have went to Mexico because their insurance doesn't cover it!
My nurse had told me there are various tests that will need to be done prior to surgery. She asked me if I had been on a 6 month weight loss program in the last 2 years. (This is a requirement for surgery) I explained to her that I had been on weight loss meds since August of 2018. She told me she would send me a form for my doctor to fill out and then I need to call the surgeon and make an appointment.
After the phone call was over, I received an email from the nurse with my provider choices and a form for my doctor. I immediately went on the website belonging to the surgeon and was able to watch an online seminar about their facility, the bariatric surgery's they offer and more. After watching the video, there is a packet that I downloaded, I think about 8 pages or so. In the process I also emailed them to let them know I was interested in their facility.
When I got home from work Monday night, I had a voicemail from their office. I quickly called them and they were letting me know about paperwork and I told them I would be filling it out and emailing it to them. So, yesterday I emailed my packet to them. They responded by letting me know that they would be entering my information, getting a hold of my insurance for proof of coverage/deductible info as well as reaching out to my doctor. After this is completed, they will call me to set up my initial visit. I feel overwhelmingly blessed.
So this is where I am at as of today, Wednesday, April 10th, 2019! Stay tuned for the next updated.