lovealways

Thanks so much for the help, guys. This forum has been so, so reliable and helpful. I'm not even sure where I heard that if VSG is not covered by insurance, and only gastric bypass, then an insurance company would make an exception fo the sleeve based on medical necessity. Either I dreamed it, or something, because I don't know where I read or heard that! hahah. Like I said, wishful thinking. At this point, I know I would consider gastric bypass since VSG is not covered. I would hate to have to go through the process of appealing, etc. So if I call my insurance company and give them the code they would be able to better assist me in seeing if VSG is covered? So far, two reps I've spoken to said only the gastric bypass. Does anyone know if there is a forum like verticalsleevetalk for gastric bypass patients? =/

Need some clarification, please! So I called my insurance company (united healthcare community plan) and they said they only cover gastric bypass. I wanted the sleeve. I heard that some surgeons are able to actually get the sleeve covered, but it is a little bit of extra work. Is this just wishful thinking? Also, I had my first consultation with my surgeon. So far, no one knows if I need a 6 month supervised diet since the patient advocate was out on vacation. I called my insurance 900 times and they said they don't see anything about a 6 month diet and that the only requirement is pre-auth. Should I go ahead and assume I don't need it or just go ahead and do the 6 months anyway?? Ahhhhhh. So frustrating! Thank you!!!! :)

So much, it seems. - attend two group support meetings - Nutrition evaluation - Psych Evaluation - Cardiologist Evaluation - sleep Study/Pulmonary Evaluation - Extensive blood work - Upper Endoscopy - A quiz to take - 6 months supervised diet with PCP And I'm just at the very beginning of it all. Lol. Long ways to go.

Oh! And I forgot to mention...it's almost 3am in NY and I can't sleep. No smoking guves me crazy bouts of energy lol.

Stay strong!! You're doing amazing at day 6! I noticed today I took my morning chantix later in the day rather than in the morning, and the cravings seemed more noticable...so your skipping one maybe had an effect on your cravings too. Good luck and keep us updated. Just remember, we're in the same boat

I probably shouldn't have mentioned I was a smoker to my surgeon, but I did because I feel I'm being held accountable now! Lol! Good luck to you. You can do this! Take it one day at a time. It gets better after 3 days? I'm finding day 3 to be a little tricky keeping the cravings at bay, but it's managable. Do you havd any Chantix side effects?

Been a smoker for 12 years, and just started Chantix. I'm currently 3 days smoke free This is a pretty big deal for me, because I've always been known for having 0 self-control when it relates to smoking. I have my first surgery consult Tuesday, and probably won't even be getting the surgery till December, but my surgeon requires everyone to quit ASAP. I figured might as well. The thing that keeps me going is knowing there's a light at the end of the tunnel...possible VSG surgery and a healthier lifestyle. For the record, Chantix has helped way better than any of the nicotine patches I've tried in the past. I like that Chantix makes the cravings seem much more managable.

What's pcip?

Oh, and for the record...ignore rude comments from rude people

Congrats!!!!!

In terms of what? Lol

Thanks so much guys!! I have United Healthcare Community Plan, which is an *** and medicaid in New York.

Hoping someone can help clarify, since I'm not insurance-savvy So I called my insurance plan and asked if they cover bariatric surgery. They said they do, but need prior authorization from the surgeon saying it's medically necessary. When I asked about requirements, nothing was said about a 3 or 6 month diet, only a BMI greater 40 or higher or 36-39 with one co-morb. Does anyone know anything about the process of getting prior auth? Is it a long process? Is it something that may slow the process? Also, if 4 different insurance reps said nothing about a supervised diet as a requirement, does this really mean there is none? Just some confusion about the prior authorization process! I have my first surgery consult July 10, so I'm just starting the journey!

Oh wow! Congrats. No 6 month diet?

Good to know. I'm pretty sure I could NOT stomach pureed meat, especially since I barely eat meat as it is. Thanks for this tip!

It could be you're dehydrated? Are you getting enough fluids?

Anyone know if straight medicaid in NY approves VSG??!

I suggest food pantrys, soup kitchens and applying for SNAP (supplemental nutrition assistance program). I also suggest TANF, which is temporary assistance for needy families. Hang in there! *hugs*

Welcome. Why 9 months??

I wouldn't worry about it! My sister gained weight throughout the entire 6 months and was approved lol. Good luck!

I'm from NY and They don't cover it here at all I would check with medicare/medicaid through your state first though and see what's up. Good luck