dlfn0926
I have been trying to get the insurance to approve this surgery for several years. I had Coventry and they type of policy it was did not allow for the surgery to be covered. I lost my job and was with Blue Cross and Blue Shield with Medicaid. At the time, Bothwell Hospital in Sedelia did not contract with Medicaid. I then got Humana, they also did not cover it because of the type of policy it was. Now, our benefits are changing January 1st and Gastric Bypass will be covered, with strict guidelines. I am hoping to get approved after the first of the year.
WOW!!! What a ride.... I guess I need to back up and bring the story up to current. As I previously stated, I knew my benefits would be changing after January 1, 2007. So I began going through all the things that I knew Coventry might require to approve me for surgery. I went to the seminar that was required by Dr. Hornbostel and started the process with him. You have to go to a seminar and send them a copy of your insurance card before you ever can get an appointment with him. I scheduled an appointment. UUUGGGHHH....nothing available until March 14th. Man!! It will take forever to get here. While I was waiting for March to get here I had a psych eval and went to a cardiologist and got cardiologist clearance. Now all I can do is what......Finally March 14th came and I saw Dr. Hornbostel. He is so good and tells it like it is. I am still feeling somewhat reserved to wait and see what the insurance company says.
March 27, 2007 I email Dr. Hornbostel's nurse Dena, who is also the best, and ask if the letter had been sent to Coventry yet for approval. She informed me that she was waiting on Dr. Hornbostel to finish his part of the letter and to check back with her in a week or so.
On April 9th I emailed her to see if the letter had been sent and she sent me an email stating, "I GOT APPROVED!!!!!!!!!!!!!!!!!!!" I about fell out of the chair. I could not believe it. I called Coventry Health Care of Kansas to make sure and they said YES. I had a surgery date of June 21, 2007. I still did not believe it. I guess I was waiting for someone to say, PSYCH. It is just a joke you are not really approved. But as time went on and got closer, no one did.
I questioned the fact that we would be going on vacation over 07/06/07 and would it be ok if I traveled. They really didn't want me traveling, so I was looking at moving my vacation back. Then out of the blue they called and had a cancellation and wanted to know if I wanted to have surgery on May 25, 2007. What was I going to tell them....NO. Heck yes I wanted that spot. This only put me six weeks out from surgery to get several things done. But all went off with out a hitch and I had surgery on May 25, 2007
08/13/07 I am now down 67 pounds and am feeling great.
08/26/2007 - I weighed today and am now down a total of 76 pounds. I am under 250 lbs. Currently now 248...woo hoo...I was stuck in a platue and was able to get through it. I am on my way down and am now looking at 240. My ultimate long term goal is to be see 199. Will it ever get here? I know it has only been three months, but I have waited so long.
10/27/07- HI all didn't realize it has been so long since I sent an update. I am five months post op and have lost a total of 105 pounds. I would like to lose another 50 or so. I will just see what happens. I am feeling great and am eating a little more. Some days more than others. My back is giving me problems but I think that is from the weight of my breast. I was a 46-48 DDD now I am down to a 40, but still in a DDD since I have skin to support and hide.
01/16/08 - Wow I didn't realize it had been so long since I had updated this info. I am now down 135 pounds. I now weigh 189. I am in a size 16. I feel GREAT other than my shoulder is still bothering me. I am sure it is the way I am sitting at the computer at work and at home, so I will have to figure that one out. We have started a support group meeting in Higginsville if there is anyone interested it meets the 2nd Tuesday of each month at 7:00 p.m. at the Magnolia Manor meeting room. Hope to see you there.
