mountain_lover

I have enjoyed reading ALL of these posts on this thread. I haven't had surgery yet, so I am looking forward to having alot of these NSV moments. I found out Wednesday that I am now approved for the SLEEVE surgery and the date is Dec. 2, so it will be soon. I did have a so called Pre-VSG NSV moment recently. I was up to 266 pounds in July and I have been slowly losing some weight, and the last time I weighed at the doctor's office I was at 239 1/2 pounds. I have not bought any new clothes, but I have been able to get into pants that use to fit until I gained all that weight. I have only kept my size 22 pants, I got rid of all my size 24 jeans because I decided I was only going to go down. Well some of my size 22 jeans were too tight because I gained weight in July. I did not want to go out to buy more pants. In August I finally got my butt in gear and started going down. I have lost only about 26+ pounds in 4 1/2 months, but today I wore a pair of jeans that were really baggy on me. The best moment I recently had was just two days ago, I was reclining all the way back in the recliner, laying flat and I told my family, "Look, I can lay flat and now I don't look like I am 9 months pregnant!!". Before when I would lay on my back my belly was big and round and sticking way up in the air. After I said that, I realized that I am losing even though I don't notice it much on the scales. I hope I will have some more moments to tell you about after Dec.2 surgery!!.

Thank you for your compliments. Yes 30+ years is so long and I am looking forward to not being obese for the rest of the days I have left. I am 55 years old and I am sure if I get healthier after this surgery I may live many more years. At the least, I can maybe feel better and enjoy the life that I do have ahead of me. I have good news!! I have been approved by Medicaid here in Ky. to have the sleeve and My surgery date is Dec.2. I will be having surgery done right here in Somerset, Ky. Thank you and I wish you all the best on your surgery in January.

I agree with your husband, that is one on the reasons I decided that I didn't like the band as much as I did in the beginning. Also I found out that I had an autoimmune disorder, so the band is not a good procedure to have. Some doctors will not do surgery at all, so when I found out that I could still have the sleeve I was so happy. I really have learned alot about the sleeve and so many people say good things about the results. I wish you all the best!! I have been approved for the sleeve, and surgery in Dec.2.

Thank You everyone for your thoughts and prayers!!!!! I have some very good news, I have been approved by Medicaid here in Kentucky for the SLEEVE and I have a surgery date, December 2. I will be having my surgery done right here in Somerset. I am so excited, I was in tears today, but it was tears of joy.----- I have had so many setbacks along the way------ I was told in the beginning that Medicaid would approve the band or duodenal, but not the sleeve and Dr. Husted wanted to do the sleeve. I was only for the Band in the beginning. Also I was told that I had Lupus, which later I found out it was not Lupus. I found out I do have an autoimmune disorder called Mixed Connective Tissue Disorder, and I was so afraid that I would not get to have surgery. But then I found out that I could still have surgery, but the Band is not usually done when people have an autoimmune disorder, so I could still have another procedure. Then when I had the testing done, I found out that I tested positive for H-pyloria, and then I had to go on the antibiotic Prev-pak to try to clear up my stomach infection, which I did not know that I had. Thank God that I was trying to have bariatric surgery or I could have ended up having ulcers or cancer as a result of untreated H-pyloria. But this delayed everything for awhile, because I had to be retested to see if the tests came back negative and they took the wrong blood test, so I had to be retested with the right one. It did come back negative, so then I was on my way again. After finally getting all the information turned in, I was told two times that I needed more information. But all things do work for the good, because now after waiting all this time, now the Sleeve is an approved procedure. Now I have so many thing to do to get ready for the big day. I am going to be starting my two week Pre-op diet of Protein milkshakes on November 18. Next Wednesday. Also I have to be weaned off of all my medication, which I take 14 pills each day. I know this will all pass, but right now it seems so overwhelming. I have been going through so many emotions since I found out I am approved. It is so real now, not just a hope. My family is so supportive of me having surgery, but everyone still worries about me having any complications from all the risks of having this type of surgery. But I keep in mind what my daughter told me, If I don't have the surgery, I could possible die from being so overweight ( MORBIDLY OBESE). In July my weight went up to 266 pounds, and anything over 100 pounds over the ideal weight is considered being morbidly obese. Even though some people do not seem to think I am, I know the facts and the scales tell all the truth, also my ongoing health issues let me know that my being overweight is a big problem in my life. My mom passed away June 20 last year, and she had many health problems related to her being obese. I wish she could have had the opportunity to have this surgery. She has also been alot of my inspiration to hang in there and not give up, so that I can possibly live a healthier, happier longer life. I hope to spend many more years with my family and friends, I am just beginning to enjoy life more and more now that I am losing weight and have the possibility of the sleeve being a tool to help me keep the weight off this time for good. Thanks again for being here for me just when I needed you!! I need all the support I can get at this time!!

Hello jsm, I hope all goes well for you. Everyone is so right, please don't stay away. Please let us know how you are doing, no matter what procedure you are going to have. We have got to know you on here and we all care. I am sorry that your Doctor does not see things the same way that you do and I wish your insurance company had different policies. One of these days maybe it will be so different and people won't have to go through what you and others, including myself have gone through trying to get approved for the sleeve. Everyone that gets approved for the duodenal switch, is having the sleeve and more done on top of the sleeve. When they realize that sometimes the more is not necessary and more risky, maybe things will change much quicker for everyone. The people that have very high BMI's and co-morbidities, maybe they do need the sleeve first, then a second surgery when they are healthier to have it after losing some weight: but for the people with lower BMI's and do not have lots of health issues, the sleeve seems to be the answer for them. It just seems so simple, If the sleeve works for so many, why do more than needs to be done? And why put the person at a greater risk of having complications? Also it would be so much less expensive for the sleeve procedure than the other more evasive surgery procedures. I do have some good news to share with you and others. I have now been approved for the sleeve and I have a surgery date Dec.2. When I first started almost a year ago, the sleeve was not approved by Medicaid here in Kentucky. Dr. Husted assured me several months ago that in the near future it would possibly be an approved procedure. Well as you can see, now it is being approved for some. I am glad that I kept hanging in there. It has been a long wait, and I had many setbacks along the way, but I am glad that it did take longer so that now I can have the sleeve instead of the other procedures.

Hello gonnaloseweight, Just remember your name and stay positive. You have came a long way and this is just the beginning. I am sure you will go far, if you just hang in there. I have been going through so much since I first decided to have surgery, but it has all been for the good so far. I just found out that I got approved for the sleeve and now I have a surgery date Dec. 2. If I would have given up because of the things that happened along the way, I would not be where I am today. I know that MY JOURNEY is really just beginning and I know there may be many more hurdles I have to jump over, but I am willing to do the jumping or come on here to get the help and support I need if something does occur along the way. Thank you for being so honest and asking for help. You are helping me and others and you may not even know it. 31 pounds is so amazing. Please post pictures as you continue to lose. I know that you are------->>>>>>gonnaloseweight!!! I am sure some of us have to take small steps and some take giant steps, but they will all get us to the finish line, if we keep on taking the steps, So hang in there, don't give up, Don't Quit!!!

Wow you are doing so good. I am glad that I read this. 25 pounds in 4 weeks is really great. You are on your way and I want to see some of your pictures soon. You are a very beautiful lady and I know that you are only going to be more beautiful. You are really an inspiration. I hope you continue to let us know how you are doing. Every comment helps, if not in the present, it will help in the future. Thank you so much.

I am glad that you posted to let us know how you are doing. It is nice to hear all aspects of post-op experiences. This way we know more what to expect or be more prepared beforehand. I just found out today that I am approved for the sleeve and I now have a surgery date. (Dec.2) I wish you all the best and thank you for giving such detail about your surgery and post-op experience. I will be glad to see some of your photos after you lose some weight. Please have a fast recovery. God bless!!

Your story is very encouraging. Thank you for posting. I may be having vsg very soon.

Well I am back with some good news and some not so good news. First of all, I have not been denied yet. All that information that was faxed to Medicaid was not enough. They called Dr. Husted's insurance staff, telling her that they needed more information. The first thing they needed was a statement from my family physician on a prescription form stating what kind of diet I had been on since I started my monthly weigh-ins. The other thing they needed was a statement from me stating if I had received all the information on risks and complications of having the surgery. So I got all the info turned into Medicaid a few days ago and we are waiting for an answer again. Maybe in a day or two I should have an answer from them. If I get approved, then I will get a surgery date scheduled. At this time, surgeries are being scheduled for the last part of Dec. The only way I can get a date sooner than that will be if another doctor gets a surgery cancellation and they give their spot to Dr. Husted. He only has Fridays scheduled for surgeries, but if he receives an opening on another day of the week due to another doctor's cancellation, than maybe he will work me in early. I was told that I would need to be on the Pre-Op diet for two weeks before surgery, so I don't want to be refused for having an earlier date just because I wouldn't have the two weeks done. I have read on some posts that others started their milkshakes early, but I just don't want to be on the milkshakes for too long. I need to ask my doctor if not having the two week Pre-Op diet completed, if an earlier date does come up, will cause any problems with getting to have the surgery. I have lost some weight so maybe he won't be real concerned if I have to stop and have surgery sooner than the two weeks. When I started in Feb. I weighed 257. My weight went up and down until July when it had reached 266. Then I really have tried to change alot of my eating. I have been going down and when I got weighed at the doctor's office a few days ago, I was at 239 1/2 pounds. I am getting around so much easier. I have been going to the Y to exercise and go to the fun and fitness swim class. I hope I can give you good news in a day or so if I get approved. Thank you for all your comments.

I hope all goes well with you. I am hoping to have the sleeve done very soon. I have a wonderful doctor. and he has explained all the different procedures and he thinks the sleeve would be the best for me. I have read so much trying to find out if this is the best way to go. In the beginning I was only for the Band, NOTHING ELSE, I did not want to have major surgery. I have since learned alot about the vertical sleeve and now I am satisfied with this decision. I have read so many positive things about the sleeve. I hope you only have to have one surgery and pray that all goes well with you getting the sleeve.

Hello jsm, I hope and pray that everything works out ok for you. I know that this has to be so frustrating for you, but one of these days soon it will all be over and you will be on your way to a new life. Please let us know if you have the surgery on Nov. 10. I have not been denied, but they did have to have some more information which I was able to obtain. Ellen, the lady at Dr. Husted's office, who takes care of the insurance, faxed it right away and we are waiting for an answer from them in a day or two. I am hoping that everything I turned in will be what they needed. They had to have a statement from me stating that I had been explained all the risks and complications of having the surgery. Also they needed a prescription form filled out by my family physician stating what diet I had been on for the months that I was doing my monthly weigh-ins since Feb. The stress and frustration have been at an all time high, but I have been trying to stay positive and just hang in there, hoping that everything works out for the good. In a few days I will post what I heard back from Medicaid. They will give me a surgery date as soon as I get approved. Dr. Husted is booked up into the middle of Dec. but if other doctors have any cancellation of surgery, then they can pass the opening to Dr. Husted. Then My surgery date would be moved up to the new opening. If I get approved, then I could possibly be having surgery this month if that were to happen or at the least I could be having it in Dec. The longer it takes to get approved, the farther out my surgery date will be, because Dr. Husted only does the surgery on Friday here in Somerset and he only can do so many in one day. His dates get filled up real fast. I know that you will be so happy to have your surgery over with and be on your way to losing weight! I pray that it will be soon and all this frustration will be over for you soon!! God bless you!!

Thank you so much! I am just hoping that everything is just what I needed to turn in. I have been at this forever it seems. I started weigh-ins in Febuary and I had went to a seminar and I was already considering having a Lap-Band Before that. I am hoping that the delays have only helped my chances of getting the sleeve approved, since in the beginning it was not approved at all, but now sometimes it is. I will let you know if I hear something this week. I put some new pictures on my photo album, because somehow I deleted the other ones. Have a good day!!

I sure hope you here some good news, I hope all goes well for you. I should find out in a few days if I get approved, I am sure you are more frustrated than you were before, but I am sure there is a reason why it is on hold that will be to your advantage one way or another. You are in my prayers!!

Hello, I recently was viewing your weight loss photos and now I find your photo on here. I am a friend of Bill's for 25 years on October 13 this month. No alcohol for that long, I stay away from the first drink. With food I have not been very successful in the past. I am hoping to be approved for the sleeve sometime this week. I have went to OA an Topps in the past, but my weight has went up and down like a yo-yo. I decided that I was sick and tired of being sick and tired and I am ready for a change. I have changed my eating habits quite a bit but I am still having a difficult time. I have started exercising at the Y and going to a swim fun and fitness class. It is becoming very addictive. I think that with food it is so difficult because it is not like cigerettes, alcohol, ect. Those things you can live without, but you can't live without food. But I am changing the way I think about it now. I constantly think about how healthy, how many calories, fat, carbs Protein ect. now that I have decided to have bariatric surgery. I haven't had a cigerette for almost 10 years or so. I know that this journey that I am traveling now is headed in the right direction and I plan on staying on the path to a better healthier long life. Have a Good day.

Hello nouveau-debut, After reading your thread on here, I decided to go back to where I posted on the Pre-Op forum and copy & paste a reply that I made to JSM to put on this Insurance and financing forum do to its content. Please read my thread titled, "PLEASE READ THIS IF YOU NEED TO APPEAL. (BCBS AND OTHER COMPANIES). I hope it will help someone. Keep us posted and let us know how it is going for you. I have been working on mine for almost a year. They just submitted my information to Medicaid here in KY. yesterday, we should hear back from them in less than a week. When I first started, the sleeve was not an eligible procedure for an approval, but now in some cases they are approving the VSG procedure. You can send me a message to let me know if this helped in any way with your situation, Have a good day!!

I previously posted this following message on the Pre-Op forum on here, I decided to copy it and paste it on this new thread about Insurance & financing. If you find it interesting, you may want to show it to your surgeon. I tried to put it down in the terms that I understand them to be, but maybe whoever is appealing your case can put this in addition to all their other information, to try to get you approved for the sleeve. PLEASE READ THIS: Re: Unapproved for Sleeve - Ready to CRY -------------------------------------------------------------------------------- Quote: Originally Posted by jsm Thanks Mountain_Lover! I am on pins and needles! I'm so nervous not knowing what the outcome of the appeal will be. I thought I would have an answer by last Friday from my surgeon's office on his peer to peer appeal. Apparently that has not happened yet. I left a message late Friday and just a little while ago. I probably have gone from a PITA (pain in the arss) to a full blown Hemmorrhoid calling his office so often. I'm also afraid to bug my insurance company, since I know my surgeon will be doing the peer to peer appeal. I'm about 2 weeks away from my scheduled surgery date, and should be starting my liquid diet on Wednesday. Again, thanks for your thoughts, prayers and good energy. I will post as soon as I hear anything. Hugs, JoAnne Hello JoAnne, I posted the following item earlier, I don't know if you noticed. If not, please read it very carefully. It may be difficult to understand. I was thinking that maybe if you were to show this following message to your surgeon, he might find it very interesting. I am sure due to the fact that he is a surgeon, that he would understand what the message is all about and he could possibly use some of it to help in your appeal. It may not help, but it might be worth trying. I am understanding from my surgeon Dr. Husted here in Somerset KY, that the vertical sleeve procedure is now being coverered by Medicaid for some patients. Just a few months ago when I went to my consult with him, they were not being approved by Medicaid, but he told me he was going to be speaking with Medicaid about getting them approved here in KY. He must have been successful or something has changed, because recently a few of his patients have been approved for the sleeve by Medicaid. I sure hope all this is true, because it has so much to do with me being able to have the sleeve done in my situation. Maybe if it is true, then other States will make it possible for Medicaid patients to get approved for a safer surgery. Also people could stay in there own area and not have to go elsewhere if they find a good surgeon who accepts Medicaid for their sleeve procedure. PLEASE READ THE FOLLOWING AND POSSIBLY LET YOUR SURGEON READ IT IF YOU THINK IT MIGHT HELP IN YOUR APPEAL!!! JSM---------- Note: this was included in your insurance policy *Biliopancreatic bypass with duodenal switch *Sleeve gastrectomy, performed either as a stand-alone restrictive procedure, or as a first stage procedure of a planned biliopancreatic bypass with duodenal switch for patients with a BMI exceeding 50. Hello jsm, I would like to point out something that maybe someone is overlooking or is misunderstanding at BlueCross/BlueShield. I may be wrong, but it is something for them to consider. If you notice above the Biliopancreatic Bypass with Duodenal Switch is approved, and it says nothing about any requirements on the BMI. But notice that when the Sleeve Gastrectomy is performed as a "FIRST STAGE PROCEDURE" of a Biliopancreatic Bypass with Dueodenal Switch, it is only approved for "PATIENTS WITH A BMI EXCEEDING 50. However, the Sleeve Gastrectomy is approved when performed as a "STAND-ALONE RESTRICTIVE PROCEDURE", it does not say any specific BMI . It stipulates that it is EITHER, Or. --------------------------------- " performed EITHER as a stand-alone restrictive procedure" "OR as a first stage procedure of a biliopancreatic bypass with duedenal switch for patients with BMI exceeding 50" -------------------------------- As I stated in my post earlier that I learned that the Duodenal Switch was being performed on patients, but if the patient had a very high BMI and health problems which made it more risky to have the Duodenal Switch, then doctors would perform the Sleeve (Which is the First part of the duodenal surgery and only restrictive), hoping that the patient would lose weight down to a SAFER, LOWER BMI, then the other part of the Duodenal surgery which is Malabsorptive could be performed without all the risks that were present before the Sleeve, so that the patient could lose more weight to reach their goal. ------------>>>>> What many doctors were discovering was that many patients continued to lose the weight and was reaching their goals with only the Sleeve, and the second part of the surgery did not need to be performed. So then many doctors started performing The SLEEVE as a STAND-ALONE RESTRICTIVE PROCEDURE. Now the sleeve is becoming a more sought after surgery by doctors and patients, because it is a less expensive, less evasive, and less risky surgery. Also the doctors know that there are less complications and healing time is faster with the Sleeve vs. the other procedures.--------------->>>>>>>> Medicaid and Medicare are now approving some Sleeve procedures. As I stated in my other post, WHY PAY FOR MORE IF IT IS NOT NEEDED. When the insurance company pays for the duodenal, the sleeve is the first part of that surgery. People with LOWER BMI and no severe health issues other than obesity, are having success with only the sleeve; so why have people put at more risk just so that they have a covered procedure according to what the insurance company understands the terms to be. Could the insurance company be misunderstanding or misinterpreting the policy coverage, because they might not have all the facts or they might not be reading the sentence above in their policy as it might be intended? If you have any thoughts on this or any more questions, it would be very interesting to hear from anyone. Thank you for taking the time to read this. Also you may get more information on this from doctors who are performing the Sleeve and are able to get it covered by different insurance policies. Have a good day from mountain_lover!! __________________ mountain_lover

I am so happy that you are doing better. I will be glad to see pictures of you after you lose some more. I posted an update on "Tell Your Story" on my thread, "Waiting! Getting Closer to having my VSG surgery". It is rather long, but I wanted to let you know all my information has been submitted to insurance to see if I get approved Finally-----!!!

Thank you very much! I was having trouble all day yesterday and today getting my doctor's office to fax my monthly weigh-in office visits and my thyroid test results to the bariactric center. They told me it would be sometime next week when they would fax them and I decided to finally go their office and sign a release form for the information to be given directly to me. She was not happy about it and made some strange comments, then told me that she would try to get them done but I would have to wait. I told her that I would wait. She realized that I was not going to leave, so then she got them done and it did not take her very long. I left and hand delivered them to the Bariatric Center, which they faxed it right then to the woman who takes care of submiting it to the insurance to try to get the approval. She called me immediately to let me know that she received them and that she had submitted them and she should hear back from them by Friday or the beginning of next week. I had been trying to get those records for over 2-3 months. I am hoping that they do not need anything else so that there is no more delays. I started weigh-ins in Feb. of this year and at that time I was told that I had to have 6 months weigh-in supervised by my family physician, which would have put surgery date sometime in August, then I was told that insurance increased it to 7 months weigh-ins. After all that I went through finding out I had H-Pylorial positive test and had to take antibiotics and be retested and finally it came back negative. Also I found out during all this time that I also had an Autoimmune disorder and thought that it might prevent me from having the surgery because they told me that it was Lupus, which after several test they found out that it was "Mixed Connective Tissue Disorder" instead. I got confirmation that it should not prevent me from having surgery. So after all of that, when my family Doctors office was not cooperating with us to get those papers faxed, I really was losing my patience. I am glad that I was able to get it taken care of today. It could have delayed surgery until possibly the beginning of next year, also it would have been that much longer that I would have to wait to see if I would get approved and then I would have had to wait for a surgery date. Now there is a chance that if approved, I may be able to have the surgery in Nov. I have really tried hard to hang in there and not give up. It has really been stressful this year, But I am hoping that it will all be worth the wait, if I get to have the surgery. As they say it is easy to put on, but hard to take off.--- SO TRUE!!.-- I am so happy that people on this forum do really care and understand what we are going through. Thank you. I will let you know as soon as they let me know if I am approved.

Hello RubyTuesday, I am so happy that you are having your surgery soon. I understand how you must feel, I have been more nervous, excited, and worrying about if I will do ok with all the changes that will take place soon if I get approved for the sleeve. I will find out hopefully this week or the first of next week. The closer I get the more I experience all these new feelings and thoughts racing through my mind. I am finding it more difficult to get regular sleep. I wonder at times if I am driving my family nuts with my constantly bringing the subject up and I know they can tell I am more excited. I am sure if you keep looking on here you will find just what will help you out at the time you need it the most. Here lately I get on this forum every night and sometimes more than once a day. I wish you all the best!!

Hello JoAnne, I posted the following item earlier, I don't know if you noticed. If not, please read it very carefully. It may be difficult to understand. I was thinking that maybe if you were to show this following message to your surgeon, he might find it very interesting. I am sure due to the fact that he is a surgeon, that he would understand what the message is all about and he could possibly use some of it to help in your appeal. It may not help, but it might be worth trying. I am understanding from my surgeon Dr. Husted here in Somerset KY, that the vertical sleeve procedure is now being coverered by Medicaid for some patients. Just a few months ago when I went to my consult with him, they were not being approved by Medicaid, but he told me he was going to be speaking with Medicaid about getting them approved here in KY. He must have been successful or something has changed, because recently a few of his patients have been approved for the sleeve by Medicaid. I sure hope all this is true, because it has so much to do with me being able to have the sleeve done in my situation. Maybe if it is true, then other States will make it possible for Medicaid patients to get approved for a safer surgery. Also people could stay in there own area and not have to go elsewhere if they find a good surgeon who accepts Medicaid for their sleeve procedure. PLEASE READ THE FOLLOWING AND POSSIBLY LET YOUR SURGEON READ IT IF YOU THINK IT MIGHT HELP IN YOUR APPEAL!!! JSM---------- Note: this was included in your insurance policy *Biliopancreatic bypass with duodenal switch *Sleeve gastrectomy, performed either as a stand-alone restrictive procedure, or as a first stage procedure of a planned biliopancreatic bypass with duodenal switch for patients with a BMI exceeding 50. Hello jsm, I would like to point out something that maybe someone is overlooking or is misunderstanding at BlueCross/BlueShield. I may be wrong, but it is something for them to consider. If you notice above the Biliopancreatic Bypass with Duodenal Switch is approved, and it says nothing about any requirements on the BMI. But notice that when the Sleeve Gastrectomy is performed as a "FIRST STAGE PROCEDURE" of a Biliopancreatic Bypass with Dueodenal Switch, it is only approved for "PATIENTS WITH A BMI EXCEEDING 50. However, the Sleeve Gastrectomy is approved when performed as a "STAND-ALONE RESTRICTIVE PROCEDURE", it does not say any specific BMI . It stipulates that it is EITHER, Or. --------------------------------- " performed EITHER as a stand-alone restrictive procedure" "OR as a first stage procedure of a biliopancreatic bypass with duedenal switch for patients with BMI exceeding 50" -------------------------------- As I stated in my post earlier that I learned that the Duodenal Switch was being performed on patients, but if the patient had a very high BMI and health problems which made it more risky to have the Duodenal Switch, then doctors would perform the Sleeve (Which is the First part of the duodenal surgery and only restrictive), hoping that the patient would lose weight down to a SAFER, LOWER BMI, then the other part of the Duodenal surgery which is Malabsorptive could be performed without all the risks that were present before the Sleeve, so that the patient could lose more weight to reach their goal. ------------>>>>> What many doctors were discovering was that many patients continued to lose the weight and was reaching their goals with only the Sleeve, and the second part of the surgery did not need to be performed. So then many doctors started performing The SLEEVE as a STAND-ALONE RESTRICTIVE PROCEDURE. Now the sleeve is becoming a more sought after surgery by doctors and patients, because it is a less expensive, less evasive, and less risky surgery. Also the doctors know that there are less complications and healing time is faster with the Sleeve vs. the other procedures.--------------->>>>>>>> Medicaid and Medicare are now approving some Sleeve procedures. As I stated in my other post, WHY PAY FOR MORE IF IT IS NOT NEEDED. When the insurance company pays for the duodenal, the sleeve is the first part of that surgery. People with LOWER BMI and no severe health issues other than obesity, are having success with only the sleeve; so why have people put at more risk just so that they have a covered procedure according to what the insurance company understands the terms to be. Could the insurance company be misunderstanding or misinterpreting the policy coverage, because they might not have all the facts or they might not be reading the sentence above in their policy as it might be intended? If you have any thoughts on this or any more questions, it would be very interesting to hear from anyone. Thank you for taking the time to read this. Also you may get more information on this from doctors who are performing the Sleeve and are able to get it covered by different insurance policies. Have a good day from mountain_lover!!

Thank you everyone for your comments. It is getting closer. I found out today that the Psych. Eval. was faxed to the bariatric center. But I found out something new, now they need to fax my thyroid test results and each months weigh-ins for 7 months. I had asked my doctor's office for copies of each doctor's office visit for the weigh-ins, but they gave me one paper with the dates and weights and told me if I needed more to let them know. Now the bariatric center is having them to fax all my records back to the beginning of the year, that way they will have everything they need. (I hope!!!!!) The woman that is taking care of all the information to turn into the insurance company is so nice and has really been a big help. She works out of her home and she has took my calls or called me back as soon as possible. She has been a blessing. She works for Dr. Husted's office here in Somerset KY. She told me that as soon as she sends it into the insurance we should find out real soon, it only takes a few days to see if I get approved. I am learning what patience is, I am getting more and more anxious to find out. I have not lost much more weight, but I have been exercising at the Y, my clothes are fitting much better. I am getting into some that I could not get into 3 months ago. I think I am firming up some. I have went to the Fun and Fitness swim class for the second time now (1 hour each session). I really enjoy it, I think it will become addictive. I am glad to hear that you are doing so well Ky.hen!! Wow 23 pounds already since Oct. 1, that is great!! I am so happy for you. You have been a big inspiration for me to hang in there.

Hello jsm, Please let us know if anything changes. I hope and pray for everything to work out for you.

My Psych. Eval. is done and all typed up. I am hoping that it is faxed to the bariatric . I am going to check on it today. The woman who takes care of the insurance told me as soon as she receives all of my information and tests that she will submit it to see if I get an approval. She said it usually takes about up to a week to hear back from the insurance. I am really getting more and more anxious. I have fell off the wagon a few times and my eating got out of hand, but I just try to do better afterwards. I have been going to the Y to exercise and I went to my first AQUA-FITNESS SWIM CLASS. I really enjoyed it and am looking forward to going again. I haven't lost much weight. My clothes are fitting better. I weighed 242 the last time I weighed at the doctor's office. With my clothes off in the mornings, I have been weighing under 240 pounds. Two days I weighed 235 and it goes up and down. After swimming on Oct.22 I weighed myself on some doctor office type scales in the locker room after getting dressed and my weight was 239. If I get approved for surgery and get a date I will be starting on the Pre-Op diet so I am sure I will lose some more before surgery. I will let everyone know what happens with the insurance.