Alright, so, I heard back from the WLS coordinator at SWMC and we found out that for sure the insurance covers 85{6e74c841b8f362d8aea590534016dc569fd3035eeb9e530df8846b42682c6656} and not 100{6e74c841b8f362d8aea590534016dc569fd3035eeb9e530df8846b42682c6656} so from here on forward this is what we know for sure.

  • Insurance will cover NOTHING pre-operative.
  • Insurance will cover surgery, up to $25,000 Lifetime Maximum so long as all three, Surgeon, Anesthesiologist and Facility are all in network. Insurance will pay 85{6e74c841b8f362d8aea590534016dc569fd3035eeb9e530df8846b42682c6656} of contracted rate, after I’ve met my $300 deductible, up to $25,000.
  • Insurance will NOT cover complications
  • Insurance will NOT cover Post Operative Follow-up

So this is what I have to work with. Now the good news! The journey is REALLY beginning! I have to go in for blood work on Saturday, July 10th, and then I have my first series of appointments on Wednesday July 14th. From what I understand I have quite a bit to do on my appointment on Wednesday, they said I will probably be there for the better part of 4 hours. I’m going to be going to two classes, meeting with the physician and meeting with the nutritionist.

We went over the list of things that my insurance requires I do before they will approve surgery, and the surgery has to be approved before hand or they wont pay, but most the things they require me to do are the same things that SWMC requires that you do within their program. So after my appointment on the 14th, I can expect to have to meeting with a psychiatrist as well. I was also told that I would probably have more appointments with the Nutritionist because I’m going to have to lose a bit of weight before they will send me to the surgeon, my BMI has to be under 60{6e74c841b8f362d8aea590534016dc569fd3035eeb9e530df8846b42682c6656}, and that’s probably going to be about 45lbs I need to lose.  We’ll see what they have to say on the 14th.

My quit smoking date was March 25th so I won’t meet the 6 month no nicotine requirement until September 25th,  so I have a bit of time to get down to what they require, I’ve crash dieted before and been successful, so I have faith that I can do it.

I feel like a huge weight has been lifted off my shoulders knowing that I am finally getting somewhere with this. Thank goodness. I have a few new recipes that I tried out last week that I want to share, but I’ll work on getting those up later this week. Jason is taking the 14th of work to go with me, so that’s awesome.  I’m eager to see what comes next. None of it his happening fast enough, I feel like it’s taking forever, but I know I’m further into the journey than I have ever been before and I’m finding a lot of contentment in that.