WHERE TO START

Hi everyone, 

i posted on here about wanting to keep this surgery a well-kept secret (if i get it) and so many you you were so helpful :) thanks

well, my next question ... where do i start ?

*i havent been to a doctor in years - probably 10 years (i know, shame on me, but i am headed in the right direction)

*my job just switched to cigna insurance and according to calculations with my weight/height, i realized i am eligible for gastric bypass to be covered by the company.

*i am almost 30 and have been overweight my entire life and really need/want this for my life

* i live in northern new jersey

*i work a full time - mon-fri - 9-5 desk job

i dont know if anyone has any input on a PCP doctor in this area, but i think i need to start there.

i plan on keeping this all pretty hush hush and i cant be out of work all of the time for doctors visits - do a lot of doctors have evening/weekend hours? is the endoscopy something that take all day ? is it a one day thing ? does anyone know of placed that do these things in the evening ? 

im really lost right now and just dont know where to start or what to do ?! 

do i make a regular wellness appointment with a doctor and just tell them that i really want to have this surgery and what do i do next ? 

any input would be awesome. thanks ! 

I would start by calling the 800 number on the back of your Cigna card; they should be able to give you a list of PCP's in your area that are accepting new patients.  You could also ask them for a list of weight loss surgeons in your area.

You might also check their (Cigna's) website.  Some insurance companies allow members to search for docs online.

And I guess you could also find the bariatric surgeons in your area and start with a call to one of them.  Usually they have an introductory workshop/class about WLS and how the processes work.  

Have you decided which surgery you want to have yet?

Try Dr Abkins in Florham Park. He is the BEST!!!

I don't live in your area, but the best advice I can give is to find a primary care physician ASAP for a full physical and any health maintenance you may need, so that health concerns can be addressed, including your desire to have bariatric surgery.  Your insurance company will have a list of in-network physicians for you to choose from.  You will have to call several offices to determine hours, especially weekend/evening hours.  As for the EGD, this procedure requires you to be put under anesthesia, so you will likely have to take the day off and will need someone to take you to the appointment and take you home. You will likely need lab work, appointments with a dietician, a psych evaluation with a mental health professional, and any other tests required by your insurance company and/or surgeon.     Once you get the ball rolling for bariatric surgery, depending on the surgeons protocol, there may be tests you will need to have that requires you to take some time off work, please consider that possibility.  Good luck to you, this is great place to start your journey, and has plenty of veterans who can provide sage advice.  

First things first - verify your insurance coverage.  Although CIGNA may cover the surgery, your employer may have opted to exclude WLS.  Call CIGNA and verify YOU specifically have coverage - no exclusion.  Also, ask them about their requirements - many insurers require a six month "supervised diet" under a physician's care -- so get a copy of their policy requirements.

Then, as others have said, find a PCP and go from there.

Good luck - hope it all works out for you.

you are marvelous! 
ugh so i totally just had a moment where i was like "i remember the woman from the insurance company saying bariatric surgery was a no-go when she was here. "

ughhhh x 218646 BUT i called cigna right before we had switched insurance and they said it would be covered. so just now i got so discouraged and called cigna and waited to hear grim news, but the woman looked up my plan and says theres no exclusions! itd be 100% covered if i go in network and stay overnight. omg !!!! i really need to get this ball going.  this would help me in so many ways and im ready to be healthy and everything that goes along with it. 

going to go home tonight and look up some PCP in the area and get this all going . 

thank you! 

That is super!  Get thee to a PCP......quick!!!

Most doctors do not have evening or weekend hours.  An endoscopy doesn't take all day, but since you are sedated for the procedure, you will probably need to take the whole day off work.  And no, I don't know any place that does endoscopies or any type of surgeries (except real emergencies) in the evenings.

Does your insurance require a referral from a PCP?  Do they require a supervised diet before they will cover WLS?  If so, you need to make an appointment with a PCP and tell him or her what you need.  Like make an appointment and say "I need a referral to a bariatric surgeon for WLS" or "I have to do a six month supervised diet with a physician.  My insurance company requires me to see you once a month and needs you to document my weight and what we discussed with regard to weight loss in my chart."

If they don't require a referral or supervised diet or anything from a PCP, then you can just call a surgeon and make an appointment.

Most insurances also require the last three years of documented proof that you were overweight. I got that from my PCP. Since you have not seen one in ten years you may want to see if your insurance requires that. If they do you need to figure that one out. Did you ever do weigh****chers in the past maybe?

The way my journey started is a little different than what most have posted, but I think it depends on where you live and what's available to you.  I looked up the bariatric center in my area, there were 2.  I did research and chose the one I thought was best and called them.  I told them my story and that I wanted to have the surgery.

They made an appointment at their office for me, gave me all the information I needed, checked insurance for me, and then proceeded.  It was so easy because they walked me through every step.

My insurance required 3 months supervised diet (which I did through the bariatric center), letter from PCP - which I got during the 3 months, ekg, endoscopy, and a couple other minor things.  So may be worth calling up your bariatric center and starting there.