Becky Sue
Stalking the insurance rep
Sep 14, 2004
Ok, so I am an INCREDIBLY weak person! Not only have I broken down and eaten nearly an entire bag of Garrett Popcorn Carmel Corn today, but I broke down and called Aetna today, too. I told myself I wouldn't call until tomorrow afternoon, but I absolutely couldn't stand it. It was like I was having a panic attack. So, at noon, I called, and (yep, if you've been reading - left a message) and 20 minutes later my phone rings. At work, I can tell whether it's an outside call or not, and it was outside, and I almost thought about not answering it because I was so scared. But I did, and it was Tammy from Aetna. She laughed at me because of the message I left her "Hi, Tammy, this is Rebecca **** ID number ***** and I know it's only been 2 days and you said it would be a couple of days and I don't want to be a pain I really don't but" ***INHALE*** "obviously I'm a little anxious and I was just wondering if you'd heard anything at all. You can call me back at *****" LOL... Geez, I'm such a punk. Anyway, when Tammy called back, she was very nice. She told me the Medical Director was out of the office yesterday, and that he a had a couple as well as mine but that she was pretty sure mine was next up and I should hear something tomorrow, Friday at the latest. So, My new goal, which I probably won't be able to keep, is to make it until Noon on Friday before I call and bug them again...
To Insure or Not Insure... That is the question...
Sep 13, 2004
So here I am, exactly one week before my thirtieth birthday... WAAAHHHHH!!! I am so depressed about it and the worst part is, I'm so disappointed in myself for being depressed. I used to make FUN of people who got all uptight about turning thirty... lol
Quick overview on what's going on: Last Wednesday I received a call back from Tammy at Aetna (she's a dear, although I've never talked to her in person). They received my stuff and sent a questionnaire to Dr. Cacucci's office to be filled out and sent back. Tammy suggested I follow up with them. So I called and left a message with Lori in the insurance department. On Friday morning, I called BACK to Aetna and left a message asking for an updated. Tammy called back and left me a message saying they're still waiting on the questionnaire so I call BACK to Dr. Cacucci's. This time I got Lori on the phone and she seemed troubled that she didn't call me back. It turns out, she forwarded the message to Heather, who filled out the form and mailed it to me so I could send it in to Aetna. Got that Saturday and faxed it yesterday. Called Aetna (you got it, left a message) to confirm receipt and Tammy called back and (un-huh, left a message) saying they received it and she was turning it over to the medical director for review. She told me I should hear something back within the next couple of days, Friday at the latest, and that she would call me. My new short-term goal is to wait until noon Thursday to call and start bugging them again... lol
I'm sooooo nervous. I want to be positive and forward focused, but I'm so scared that they will deny me. I think it's 95%... I already talked with DH last night and he supports me getting a lawyer (Lindstrom, maybe) to help me with the appeal, if necessary. Hopefully, I won't have to go that route... I'll check back in as soon as I hear something. Prayers for me? Please???
Quick overview on what's going on: Last Wednesday I received a call back from Tammy at Aetna (she's a dear, although I've never talked to her in person). They received my stuff and sent a questionnaire to Dr. Cacucci's office to be filled out and sent back. Tammy suggested I follow up with them. So I called and left a message with Lori in the insurance department. On Friday morning, I called BACK to Aetna and left a message asking for an updated. Tammy called back and left me a message saying they're still waiting on the questionnaire so I call BACK to Dr. Cacucci's. This time I got Lori on the phone and she seemed troubled that she didn't call me back. It turns out, she forwarded the message to Heather, who filled out the form and mailed it to me so I could send it in to Aetna. Got that Saturday and faxed it yesterday. Called Aetna (you got it, left a message) to confirm receipt and Tammy called back and (un-huh, left a message) saying they received it and she was turning it over to the medical director for review. She told me I should hear something back within the next couple of days, Friday at the latest, and that she would call me. My new short-term goal is to wait until noon Thursday to call and start bugging them again... lol
I'm sooooo nervous. I want to be positive and forward focused, but I'm so scared that they will deny me. I think it's 95%... I already talked with DH last night and he supports me getting a lawyer (Lindstrom, maybe) to help me with the appeal, if necessary. Hopefully, I won't have to go that route... I'll check back in as soon as I hear something. Prayers for me? Please???
Operation: Insurance Approval
Sep 07, 2004
Wow! So, it's been a long time, huh? So, what's going on with me? Hmmmm.... Well, I sent my insurance paperwork in yesterday. I feel like I'm going to puke now. I've completed about 2/3 of my PCP diet, and Aetna says they'll approve prior to completion as long as you finish it before surgery. I don't have 5 years worth of weight history. My PCP just doesn't weigh me every time, so I'm not sure how that's going to work out... I'm so nervous; I almost wish I hadn't sent it in at all. The lady I spoke to yesterday was really nice, opened a file for me and gave me the fax number, etc., etc.,
So, I guess it's just wait and see. I called today to confirm that they've received my paperwork, left a voice mail on their "CONFIDENTIAL MAILBOX" and was promised a call back within 24 hours... So... I don't know. Nothing else much to say. I've been away from the boards a lot because the grueling slow place is just driving me nuts and I needed a break.
I'll check in when I hear something...
Wish me luck!
So, I guess it's just wait and see. I called today to confirm that they've received my paperwork, left a voice mail on their "CONFIDENTIAL MAILBOX" and was promised a call back within 24 hours... So... I don't know. Nothing else much to say. I've been away from the boards a lot because the grueling slow place is just driving me nuts and I needed a break.
I'll check in when I hear something...
Wish me luck!
Plugging along...
Jul 31, 2004
Another day, another pound... hee hee hee.... I'm doing my doc-supervised diet (still) and have been trading the same 5-8 pounds for the last 2.5 months... I've discovered I have a really serious problem with Chex Mix. I've been eating it like it's going out of style - half a bag a day... I told my DH not to by anymore because I obviously can't handle the temptation... I've also started cutting back on my soda as it was getting out of hand, too... I drink Diet Rite - Sodium/Caffeine/Sugar free, but still. I'm back to drinking more water and Crystal Light. I don't have any grand illusions that I'm going to drop 30 pounds in the next 3 months, but it's kind of ridiculous, I don't think I've been trying as hard as I could have.
I'm getting worried, again, about approval. I keep hearing people talk about Aetna dropping WLS at the beginning of the year, but I could never find any real proof, just rumors. Yesterday, I found an article stating that Aetna is going to drop WLS from it's general coverage the first of the year, and it will only be included if a company picks up the rider. That makes me REALLY nervous, because I have a pretty good feeling my company won't.... So, I'm going to be cutting it really close. If I can get approval in September, 2/3 into my diet, I should be ok. My diet will be over in November, which will give me JUST enough time... If not, I may be screwed. I don't know whether the other insurance option (Cigna) will have an exclusion or not, plus, the cost is WAY more. 75/month family for Aetna, close to 300/month for Cigna....
I'm not going to let it bug me right now, though (yeah, right) cuz there's really not a whole lot I can do about it. Just take it as it goes, I guess. There's always self pay. I might be able to scratch together some savings, loan out of my 401K, family members, etc., and come up with enough, but that's last resort. I'll worry about that if and when I have to. For now, I'm just going to keep plugging away and pray for the best.
I'm getting worried, again, about approval. I keep hearing people talk about Aetna dropping WLS at the beginning of the year, but I could never find any real proof, just rumors. Yesterday, I found an article stating that Aetna is going to drop WLS from it's general coverage the first of the year, and it will only be included if a company picks up the rider. That makes me REALLY nervous, because I have a pretty good feeling my company won't.... So, I'm going to be cutting it really close. If I can get approval in September, 2/3 into my diet, I should be ok. My diet will be over in November, which will give me JUST enough time... If not, I may be screwed. I don't know whether the other insurance option (Cigna) will have an exclusion or not, plus, the cost is WAY more. 75/month family for Aetna, close to 300/month for Cigna....
I'm not going to let it bug me right now, though (yeah, right) cuz there's really not a whole lot I can do about it. Just take it as it goes, I guess. There's always self pay. I might be able to scratch together some savings, loan out of my 401K, family members, etc., and come up with enough, but that's last resort. I'll worry about that if and when I have to. For now, I'm just going to keep plugging away and pray for the best.
Roller Coaster Fiasco
Jul 24, 2004
Ok, it's been awhile since I've updated. Probably because I'm just kind of blah and depressed at the snail's pace... I had my psych evaluation, and it went fine. 20 minutes in and out... I've got to re-quit smoking though, and right now, because I've got to be clean for 2 months or she won't do the surgery. WHY did I ever start again? That was SOOOOO STUPID!!!
Took Holden to Cedar Point yesterday. That was a total bummer. We waited in line for the Blue Streak for over an hour. His first roller coaster... I didn't fit. I had to try and wedge my butt in to this narrow little molded seat, and it had a seat belt... I would have been ok if it were just the lap bar, but there was NO WAY I was getting the seatbelt on. So, I'm like panicking. I kept saying, "I won't fit, Holden. I can't fit. I'm sorry, I can't do it..." I asked him if he wanted to go by himself and he said yeah, but I think he just wanted me to go because he was so embarrassed. He's only 9. So, I got off, he went by himself, and the rest of the day was just kind of... bleh. We rode a couple of other "safe" rides, because I didn't want to go through all of that again. . It was really depressing. He was really good about it though, and we still had fun. Luckily, he wasn't really into the great big new roller coasters. I just had it eating away at the back of my brain the rest of the day...
I go to my PCP on 8/17 and will be getting my records from him and then sending everything in. I'll be about 3 months into my 6 month diet but I'm hoping they'll go ahead and approve anyway. A friend of mine got approved and her most recent physician supervised diet was from 99... So, wish me luck!
Took Holden to Cedar Point yesterday. That was a total bummer. We waited in line for the Blue Streak for over an hour. His first roller coaster... I didn't fit. I had to try and wedge my butt in to this narrow little molded seat, and it had a seat belt... I would have been ok if it were just the lap bar, but there was NO WAY I was getting the seatbelt on. So, I'm like panicking. I kept saying, "I won't fit, Holden. I can't fit. I'm sorry, I can't do it..." I asked him if he wanted to go by himself and he said yeah, but I think he just wanted me to go because he was so embarrassed. He's only 9. So, I got off, he went by himself, and the rest of the day was just kind of... bleh. We rode a couple of other "safe" rides, because I didn't want to go through all of that again. . It was really depressing. He was really good about it though, and we still had fun. Luckily, he wasn't really into the great big new roller coasters. I just had it eating away at the back of my brain the rest of the day...
I go to my PCP on 8/17 and will be getting my records from him and then sending everything in. I'll be about 3 months into my 6 month diet but I'm hoping they'll go ahead and approve anyway. A friend of mine got approved and her most recent physician supervised diet was from 99... So, wish me luck!
Narcolepsy???
Jul 07, 2004
Well, my puter died and went to heaven. I'm lost at home without it. I've been going to dad's to check email, and checking in here at work, when I'm able... Let's see, what's happened lately?
Oh yeah, I got my results back on my Sleep Study... I don't have Sleep Apnea (YAAYY!!!) but, kinda funny, the doc thought that I *might* have narcolepsy... tee hee hee... That's funny because Aaron and I also refer to my sleepiness as my "little narcolepsy problem"... as a joke, of course. The tentative thought of narcolepsy comes from the fact that when they made me stay all the next day and nap four times, I fell asleep within 1 minute each time... After 8.5 hours of sleep the night before. The doc says that's not normal. I told him I was bored... What ELSE are you going to do? Right? He said, even if I were bored, that's not normal... Leave it to me to not be normal... lol
But, even though I fell asleep, it wasn't a deep sleep, so he's at a loss. He talked about trying medication to see if that helped, but to be honest, it seems to have gotten better, a little, so we're going to wait and see. I'm getting a little more sleep at night, REALLY watching my caffeine intake, especially in the afternoons and evenings, and trying to get a little more exercise... We'll see what happens... He says it could be a mild case of narcolepsy or stress, although we couldn't really pinpoint any stress that would have caused this... I'm just glad I don't have to wear a CPAP machine!
I have my psych evaluation tomorrow in Carmel. Wish me luck! I'm going to have to try really hard to not come off crazy! lol
Oh yeah, I got my results back on my Sleep Study... I don't have Sleep Apnea (YAAYY!!!) but, kinda funny, the doc thought that I *might* have narcolepsy... tee hee hee... That's funny because Aaron and I also refer to my sleepiness as my "little narcolepsy problem"... as a joke, of course. The tentative thought of narcolepsy comes from the fact that when they made me stay all the next day and nap four times, I fell asleep within 1 minute each time... After 8.5 hours of sleep the night before. The doc says that's not normal. I told him I was bored... What ELSE are you going to do? Right? He said, even if I were bored, that's not normal... Leave it to me to not be normal... lol
But, even though I fell asleep, it wasn't a deep sleep, so he's at a loss. He talked about trying medication to see if that helped, but to be honest, it seems to have gotten better, a little, so we're going to wait and see. I'm getting a little more sleep at night, REALLY watching my caffeine intake, especially in the afternoons and evenings, and trying to get a little more exercise... We'll see what happens... He says it could be a mild case of narcolepsy or stress, although we couldn't really pinpoint any stress that would have caused this... I'm just glad I don't have to wear a CPAP machine!
I have my psych evaluation tomorrow in Carmel. Wish me luck! I'm going to have to try really hard to not come off crazy! lol
Hello, my name is Becky and I'm a caffienaholic!
Jun 20, 2004
Ok, I'm going to whine for a minute. It's 4pm and I just got home from the hospital a little while ago. ARGHHH!!!! I can't BELIEVE I had to stay all day! I sat around doing nothing for 2 hours at a time, and then would have to "nap" for 25 minutes. FOUR TIMES I had to do this. To make matters worse, I couldn't have any caffeine, and by the time they did let me go, I was almost in tears with a migraine. I REALLY need to do something about this caffeine thing... I almost held up the coffee cart in the hospital lobby. Unfortunately, I had no cash on me so I had to wait to get home. I slammed 2 Pepsis, 2 Tylenols and now on my second cup of coffee and am starting to feel better....lol
I have no idea why I had to stay, I guess I'll find out on the 30th when I go back to the Pulmonary guy...
"Hello, my name is Becky, and it's been 13 hours since my last cup of coffee...." tee hee hee
I have no idea why I had to stay, I guess I'll find out on the 30th when I go back to the Pulmonary guy...
"Hello, my name is Becky, and it's been 13 hours since my last cup of coffee...." tee hee hee
Getting ready for my sleep study...
Jun 19, 2004
Ok, my sleep study is tonight and I have mixed emotions about it. One, I'm just sort of annoyed... Don't wanna do it, it's gonna be a pain, etc. I'm not scared or anything... Just the thought of trying to go to sleep with a bunch of wires and people watching me, seems goofy. On the other hand, I'm probable for apnea so I'm glad I'm getting it checked out and I know if I do have apnea, it will help with my insurance case. Also, I'm just one step closer to doing all I need to do to get approval.
So, not really much to say... Just hanging out, doing laundry, waiting to go to the hospital... yee hah.... lol I'll fill you in on my marvelous one-night vacation (lol) tomorrow.
So, not really much to say... Just hanging out, doing laundry, waiting to go to the hospital... yee hah.... lol I'll fill you in on my marvelous one-night vacation (lol) tomorrow.
First Support Group Visit
Jun 14, 2004
Well, I went to a support group meeting that St. Vs holds up here. To be honest, I didn't really want to go, it was more of a brownie points thing with insurance than anything else. Plus, Dr. Cacucci really stresses that we have to go after the surgery, so I figured I'd go now... Big surprise - it wasn't that bad. There was a lot of good discussion going on and a lot of laughing, too. Plus, I met someone there in person that I've talked to here, and that was cool, too. Anyway, I'm glad I went and will probably go for the duration, now. 'Night 'night!
Aetna Requirements
Jun 14, 2004
Yesterday, I emailed Aetna (again) with questions I had regarding their policy. I like the email option, because, as someone on OH pointed out, they're quick to respond AND you have it in writing. So, my questions were 1) Is there a written exclusion for WLS that my company put in. I knew the answer was no, because others here have had the surgery, but I wanted it in writing. 2)Can you give me any guidelines on the 6 months? As you know, if you've read this far, I've been really worried about meeting their requirements to a T. I was afraid that the way my doctor set it up, weighing weekly with the company nurse and not seeing him for 3 months. It seemed like everyone else was going to the doctor weekly or at least every 3-4 weeks. I received a response from Aetna today and they confirmed that there was no written exclusion at that there were no set guidelines for the physician supervised diet. Specifically, she said "There are no specific guidelines for how often you see your physician and as long as your visits to the registered nurse are documented in the physician's office note, you should not need to see him more than he recommends." Yee ha! I feel so much better! So, I've got my sleep study on the 20th, and I think I'll go ahead and schedule my Psych eval down at St. Vincent's. Once I get that stuff back, I'm going to go ahead and send it in, with the hopes that they'll approve contingent on finishing my 6 month diet... Wish me luck!
About Me
Fort Wayne, IN
Location
23.2
BMI
Surgery
05/17/2005
Surgery Date
Apr 12, 2004
Member Since
Before & After
rollover to see after photo
Taken shortly after I decided to have WLS
275-280ishlbs
10 Months Out
160ishlbs
