Good news, well depending on how you look at it. Since I have had my sleep test and have to go on a CPAP, my PCP finally agreed to send my referal paperwork in

I also have UHC insurance through my employer that I have paid premiums on for 10 years and they have done the same thing. I work for a small company with 45 employees (world-wide) and I just happen to be the only one that is morbidly obese and in need of WLS.
Not unlike most, they have negotiated the exclusion from coverage for "WLS, Weight Management Programs of any kind, and Doctor -Supervised Diets, even if medically necessary, for morbid obesity - for any reason," to "keep the premiums as low as possible for everyone."
I have found out that this "exclusion-language" is pretty much rock-solid and I'm unable to get my surgery covered with insurance, in any way, because of it.
I've spoken to several patient advocates, their consensis is the same. It truly sucks!

I have gone to my company executives and asked for them to change our insurance coverage, so I have a chance to get healthy thereby costing less in medical expenses for both them and I, but the response was a resounding "No, not gonna happen."
So I even went so far as to ask the president of the company if he would consider authorizing financial assistance from the company to help me pay for the surgery, since their negotiations have prevented my coverage. That question got the same response.

It's difficult, depressing and debilitating, to say the least, when you have to deal with people whom have the audacity to think they have the right to make life-altering decisions for you, pertaining to your health, even though they know nothing about your life and the health conditions that you struggle with daily. I feel greatly discriminated against because of this, but also because almost everyone I work with thinks that WLS is a cop-out, a lazy person's answer to loosing weight. This attitude is one of the reasons why we obese people have so many problems with very prevalent discrimination in society.

I found a petition on one of the ObesityHelp blogs that is asking the government to force insurance companies to include WLS surgery in their coverage for morbid obesity. It's short, but to the point. It says that we should not be denied treatment of any kind for our obesity disease when the law provides for drug and alcohol addicts the same protection of coverage as we are asking for.

I would encourage you to seek and find that petition and sign it. And I encourage you to petition in any and all other ways possible to get the coverage you need. But please don't let the negative responses discourage your efforts. I am not letting them stop me and I hope we both will find a way to achieve the necessary financing we need without having to resort to putting ourselves in harms ways to do it.

Good luck! = ; }

Hey Everyone,
  I'm new here and have a few questions...
On January 25th I visited with my Dr. to get a referral for RNY. She agreed that surgery would be a good option for me. So she has sent the request to Tricare Prime (North) to approve the referral with a Bariatric Surgeon. So here are just a few questions I have.
 
1. Has anyone else here gone through Tricare Prime (North) ?
2. How long did it take to get in to see the surgeon?
3. How many of you had to go on a preop diet, and how long was the preop diet?
4. How long did it take for you to get your surgery from first consultation with surgeon to surgery date?
5. How long was your stay in the hospital?
6. How did you feel after surgery?
7. Does anyone have any regrets about the surgery?
8. Who was your surgeon?
9. If there was one thing you wish you knew before you had surgery, what would it be/ Any words of wisdom?
10. When do you think I should contact Tricare to see how my referral is going?
11. Will they choose the surgeon for me?

Thank You! Courtney!!

Hi Everyone,

I can remember how I searched these boards trying to figure out what to do when I wanted to have Weight Loss Surgery. Where should I go since I was paying for it.  I wanted the best I could find even if it was in the US. 

The one name for a doctor that just kept coming up over and over with great reviews about him was Dr. Aaceves. He is in Mexicali, Mexico-- a very safe board to cross.
 
I just want you to know that it has been 3 1/2 years since I had my WLS with Dr. Aceves.  He is fabulous, and his entire staff are highly qualified.  I was 63 when I had the surgery and I am 66 now.  I lost 105 pounds and have kept the weight off.

He gave me the tool to do it, and it did require work and effort on my part too. 

Please feel free to ask me any questions that you might have about Dr. Aceves and his excellt hospital and staff.  There are all kinds of ways to finance your surgery too.  You know we never think twice about making "car payments" well how about making some body payments--you are worth every dime you will spend to be healthy.

Hugs,
Suzanne

Hi Jackie,

I am 5'4" and weigh 216 at the moment. My BMI is 37. My PCP says that Kaiser won't qualify me under 40 BMI with just high blood pressure (even though it takes 2 meds to control it). I did the sleep test and was told I have mild apnea + a heavy snoring problem. I am scheduled for a sleep info class tomorrow. I have to sleep with a special CPAP fro a week that will further record my paterns, then they will determine if I need a CPAP. If so, I think I can make my case. If not, I think I will write a detailed letter about why I think this is the right choice for me.

The bummer is I think Kaiser has stopped using Pacific Bariatrics in San Diego, which means a different surgeon. I was really hoping for the same doc as hubby, but that is not likely going to happen unless I win the lotto and can self-pay. I know I couldn't possibly afford this medical group/hospital on my own.

Congratulations on being almost finished with your classes. Do you know where they are sending you for surgery yet?