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talksoupslp
Marietta, GA
Member Since: 04/07/08
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!

After I heard about the "fat tax" in Alabama, I thought about when they would add one of those here in GA.  I'll pay the tax, but then they need to use that "tax" to pay for WLS!

-Elli

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Uzed2Bthin
Member Since: 05/24/08
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
Yeah my dh has state health plan ICK  I called them and they told me no - so I said...oh you are more than willing to pay for my long term health issues but wont pay for the BAND and they said YES - I then asked them how stupid were they.  Thank goodness I have sep insurance that did just pay for mine.  Keep battling them - because you and I both know that pretty soon they will had a fat tax to the premiums - they have already added smoker.  We are next.  
 
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talksoupslp
Marietta, GA
Member Since: 04/07/08
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
You are VERY right.  Unfortunately, I doubt it will make an impact for the new insurance year.  Maybe next year.

-Elli
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Amy Williams
Augusta, GA
Member Since: 08/13/02
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
This is basically the same letter I received.  It did have a tiny section mentioning what I talked about my husband and I having surgery when the benefit was offered for the state.  I have another support meeting tonight, so I plan on handing out the address and numbers again.  We have to keep on them.  The more people who complain and write the more likely they will be to try to make changes in the policy. 
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talksoupslp
Marietta, GA
Member Since: 04/07/08
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
Good, I'd be real interested in what they wrote you.  I got my letter yesterday from the Dept of Community Health.  I'm not all that impressed with the letter.

First of all, Dr. Medows is not the one *****sponded.  It was a Trudie Nacin, the Deputy Chief of the SHBP.  She started out with quoting me the paragraph from our benefit book about not covering the surgery.  Well, no duh!  I think I mentioned it page and verse in MY letter to THEM. 

The letter goes on to say:
"The basic purpose of the SHBP is to provide healthcare coverage for the treatment of illness or injury of our members and their enrolled dependents.  While the Plan covers most diagnoses and treatment, policy and regulations have limited or excluded coverage of certain services regardless of medical necessity, such as the surgical management of weight loss.  State law allows the Department of Community Health to design the benefit plan in such a manner that promotes the fiscal strength of the Plan as well as the strongest possible mix of benefits and services to SHPB members.

Periodically, the Department does review and re-evaluate procedures that are excluded from coverage to assess for any changes or new developments that might otherwise result in a benefit change.  We will include an evaluation of gastric-restrictive procedures in our future deliberations.

I certainly understand your frustrations regarding your specific medical needs and while I may not have provided favorable answers to your inquiries, the SHBP and all of its employees remain committed to providing quality health care services and customer service to its members."

Yea, right!  Obesity is an illness and they need to cover it.  I think it's discrimination.  I guess we'll see what happens next.  I called UHC yesterday and the customer no-service rep was arguing with me.  "Why did I file my own pre-authorization determination?"  and "Why did I bother, WLS is excluded."  She finally looked in the computer to see that a "letter was requested on August 29th".  I assume it's a denial letter, but I haven't received it yet.  I wi**** would arrive so I could get this ball rolling.

-Elli
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GAman
GA
Duodenal Switch (07/03/08)
Member Since: 06/23/08
[Latest Posts]

Topic: RE: Hi, I'm new...
Hi Alison! 
I had the DS with Dr. Smith on July 3rd and I wasn't scared a bit.  My surgery ran way long and I had no problems.  I knew what to expect because Dr. Smith's program was so thorough.

I do remember being in the room after the surgery saying Oh crap what if I dont like it?  What if it doesnt work?  But over the days, I realize it does work.  I found going to group and talking with other people (which was not my thing when I began) was really helpful, especially after when you wonder what is happening to you is normal. 

The short answer is we all felt this way.  hang in there.  Its worth it

John
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GAman
GA
Duodenal Switch (07/03/08)
Member Since: 06/23/08
[Latest Posts]

Topic: RE: Support groups in or near Paulding County
Hey Darrin:

There is one in marietta at the wellstar center on Windy Hill on the 3rd Thursday of each month at 6:30.  That would be a little closer.  There are all types of surgeries there...
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Amy Williams
Augusta, GA
Member Since: 08/13/02
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
Elli,

I received a personal letter from the state plan yesterday.  When I get home I'll write in here what they said.  It sounded like it was somewhat promising, but we need more people to write and call!
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luvsexytrstno1
Anchorage, AK
Member Since: 11/11/04
[Latest Posts]

Topic: So pretty! So Fat! So Sad!
http://luvsexytrstno1.blogspot.com/2008/09/so-pretty-so-fat- so-sad.html
This is a tag line above a photo of a larger girl in her underwear.  This is a real ad!  I am so disgusted!  read more at my blog and see the actual ad.  We need to stop buying from companies that use these types of demeaning ads.
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BrookieWookie
Member Since: 08/24/08
[Latest Posts]

Topic: RE: I have my bags packed!
Thank you so much.  God bless you too.  I cant wait i am leave tomorrow morning.
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GAMOM23
Hinesville, GA
Member Since: 08/14/08
[Latest Posts]

Topic: RE: Hello Again and Again
Thanks for the good news... I feel really good about everything, just nervous.... its always good to hear what others experience to back those feelings up....

Dee
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Deborah T.
McDonough, GA
Member Since: 04/05/08
[Latest Posts]

Topic: RE: I have my bags packed!

I am so glad for you.  My surgery is Thursday also.

God Bless You,
Deb

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Amy Williams
Augusta, GA
Member Since: 08/13/02
[Latest Posts]

Topic: Augusta Support Meeting September 4th
This is just a reminder about our monthly meeting.

If you haven't come, we'd love to meet you.  Anyone is welcome.

Thursday September 4th, 2008
Trinity Hospital of Augusta
7:00 to 8:30 pm  (Gastric Band and Bypass group)
Ground floor in the Sister Mary Louise Conference Room

For more information visit www.augustaobesityhelp.com

Hope to see you there!  


I work with an awesome bariatric program in Georgia 
  I've lost over 400 pounds!  
I love helping others, if you have a question just ask!  


Click on a link to read more about my journey:  
My website   My reconstructive photos  My story on MTV  Update MTV story


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Amy Williams
Augusta, GA
Member Since: 08/13/02
[Latest Posts]

Topic: RE: Which insurance approved you?
These are some that do pay for the surgery.

AT&T
Wachovia
Target
Alltel
Comcast
T-Mobile
Starbucks

These are some well known companies that have coverage for bariatric surgery, usually small companies don't have the benefit because of the costs.


I work with an awesome bariatric program in Georgia 
  I've lost over 400 pounds!  
I love helping others, if you have a question just ask!  


Click on a link to read more about my journey:  
My website   My reconstructive photos  My story on MTV  Update MTV story


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Amy Williams
Augusta, GA
Member Since: 08/13/02
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
Thank you so much.

Elli,  I will tell you they have given everyone a complete run around.  The State Health plan has made it very clear to me that the governor has the final say so in the budget and he would be the only one to override the decision.  I have call Rhonda's office on several attempts myself, they will never take a message, I have even written to her.  At this point through we all need to write and call whom ever will listen.  Enough people complain they will realize this is a BIG issue.


I work with an awesome bariatric program in Georgia 
  I've lost over 400 pounds!  
I love helping others, if you have a question just ask!  


Click on a link to read more about my journey:  
My website   My reconstructive photos  My story on MTV  Update MTV story


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BrookieWookie
Member Since: 08/24/08
[Latest Posts]

Topic: I have my bags packed!
I am flying out to Dallas, TX on September 3rd and having my lap-band on Sept 4th.  Can anyone tell me what I am looking forward too?  I am ok but getting nervous the closer it gets.I still cant wait.  Thanks for reading.   If you had the lap-band done in August I would like to here about your weight loss and story.  Thanks ~*Brooke*~
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Ginger L.
woodstock, GA
Member Since: 07/22/04
[Latest Posts]

Topic: RE: Protein Shakes
Have you tried to put strawvberries in the vanilla?  I can tolerate it with fruit in it but not alone. Goodluck!



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janetrnc
Ludowici, Ga
Member Since: 01/07/04
[Latest Posts]

Topic: RE: Protein Shakes
I have the baratric advantage chocolate and vanilla. put them in the blender with ice and skim milk and they are quite palatable.
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janetrnc
Ludowici, Ga
Member Since: 01/07/04
[Latest Posts]

Topic: RE: Hello Again and Again
Dr. Kent and the hospital staff are simply fabulous! I am a nurse so I know good care when I get it! :) I didn't have any problems at all. The office staff is terrific too.
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talksoupslp
Marietta, GA
Member Since: 04/07/08
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
They aren't going to brush me off without a fight.  I have applied for pre-authorization for WLS.  Once I get my denial, I will hire an attorney.  I realize that the attorney may look at all the info from our health plan and say he won't take the case, though I'm hoping to fight...they won't be able to "brush me off" then.
-Elli
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secail
Riverdale, GA
Member Since: 07/30/07
[Latest Posts]

Topic: RE: Update...GA State Employees Look Here!
I have address the issue to the Dept. of Community Health regarding wls.  No one has ever acknowledged me regarding the issue.  They just kept brushing me off.... employees are never asked for their opinions.
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dec721
Avondale Estates, GA
Member Since: 04/03/08
[Latest Posts]

Topic: RE: Protein Shakes
The Slimfast low carb tasted the best to me, but since I am lactose-intolerant it sat in my stomach like a rock.  Same with sugar-free Carnation Instant Breakfast, but it tastes okay.  Some people like the New Whey protein "bullets"; I can choke down a 25g one diluted with water, but the 42g ones taste foul to me.  Since I can barely stomach any of them, I have been decidedly lacking in protein my first few weeks.  Hope you have better luck than I!!    --Dorothy
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cuteasabug77
Member Since: 08/29/08
[Latest Posts]

Topic: Protein Shakes
Okay, I haven't received my date of surgery yet but I am trying to prepare myself for Post-op.  I have tried the Vanilla Unjury protien shake & just about threw up!  It was absolutely horrible!!!!  Not to mention the awful smell.  I have Unjury Chocolate, Strawberry Sorbet, & CHicken Soup flavors but I am almost to scared to try them.  Any suggestions on a protein drink/shake that is better than what I have experienced?     
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tenache
Lawrenceville, GA
Member Since: 12/22/04
[Latest Posts]

Topic: RE: I Have a Date!!!!

Congrad!!! My date is Sept 25!!! Can't wait to join the loser bench




 

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tenache
Lawrenceville, GA
Member Since: 12/22/04
[Latest Posts]

Topic: RE: 11 days out ..AMAZING
CongradI wish you the best. My date is Sept 25 so I hope I can have the same attitude that you have.
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Becoming Anne in 2008
GA
Member Since: 09/13/07
[Latest Posts]

Topic: RE: Hiya Georgia!
Hi Pixiemom...sorry it took so long for me to get back with ya.

Look at obesitysolutions.com

The support group is on Tuesday nights at Lanier Park Hospital on white sulphur road.

Its a good meeting.

310/200/144(for now this is my goal weight)  Before/Current/Goal
was 315 pre-surgery
      

 
 

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talksoupslp
Marietta, GA
Member Since: 04/07/08
[Latest Posts]