Morgandobes

Hi all Just posting for those who have Anthem Blue Cross Blue Shield. For MY employer(I hear employeers can have different coverages), They will cover the sleeve with pre-certification and medical necessity needs to be shown. They then cover 80% with a 1,000 deductible, then up to 2,000 out of pocket then they pick up the rest. Just in case anyone else has this insurance company. Lisa

Thanks everyone for the responses, you guys are an awesome bunch!

Thanks Bored! I am glad to hear that about the reflux, I think I would rather die from being fat than from esophogheal(sp?) Cancer! I cant wait! I have a scope scheduled next week, Anthem BCBS needs to be show 'medical necessity', so the doc scheduled a scope. He wants to take the band out, let my stomach heal, then do the Sleeve. I am SO excited from talking and listening to you guys. My step is lighter and I can already feel the depression lifting with the hope of losing all of this fat and maybe going swimming later this summer and not be TOTALLY embarassed. Thank you, Lisa

Thanks Thinoneday! Thats what the doc told me was that 'it doesnt stretch' and when I talked to his receptionist a couple of weeks ago, she told me that the vertically shaped pouches dont stretch either, she said she had her pouch from her gastric bypass redone to a vertical pouch. But, I was searching this morning on the 'net' and one of the bariatric sites listed pouch stretching as a 'disavantage' to the VSG. Just trying to see what I can see. Lisa

Hi Yall I wanted to ask the experts, I am pre-surgery, but I am wondering. I asked the doc in the consult about the 'pouch' stretching like my gastric bypass friend says hers did and he told me 'it does not stretch' Is this true? Will I find myself 5 or 6 or 7 years out and find I can eat as much food as I do now?(or almost). Also, I have acid reflux VERY bad with the band that is currently in. What has been the word with the sleeve and reflux? At least with the band I can get rid of it and get my reflux under control, but since this is permanent.. Thanks in advance for any thoughts, Lisa

Thanks Tiffykins! I talked to my nurse today and she says that blue cross blue shield needs "medical necessity" shown. So, I have an 'scope' scheduled for next tuesday. Hopefully have this band taken out ASAP! Lisa

Hmm...sounds like you wont get enough for him to cover your surgery, he may only cover a co-pay! Seriously, I wish you luck. I did the lap-band in 2005, and it wasnt that bad. A little scary when you first start to go under, but find a surgeon that you like and that you trust, that is the key. Besides, if you have already had c-sections, I would think that would be a lot more painful that a laproscopic surgery! Lisa

Hi everyone You guys have a great forum here, LOTS of helpfull information. I was banded in 2005 at about 295. I was scared of the bypass, so I opted for the band. I lost approx 70 lbs by 2007, and was doing well, but then my weight started creeping back up. I also have had terrible, uncontrolled heartburn. Then I started getting stomach aches from trapped gas(I think from the hearburn) that didnt have a place to go and wouldent come up. I had the barium swallow and they didnt see anything wrong, so I had a complete unfill the first of march 2010. I was researching and a friend of mine got the bypass 11 years ago. She losted 130 lbs give or take, but now struggles with weight again. Although thats not exactly what I wanted, I have gained back up to approx where I was pre-band. I went and talked with a local bariatric surgeon, Timothy Brown, and he suggested the vertical sleeve gastrectomy. I hadnt done any research on this one, hadent even really heard of it. He said he thought the key was to get rid of ghrelin, the hunger hormone and that the eating issues would resolve themselves. He said he had discussed it with other bariaritic docs and they thought it was the best operation far excluding the bypass. Anyway, I rushed home to do my research and am pleasntly surprised with what I found. It would be awesome to occaisonally have a bite of sweets without 'dumping' Anyway, hopefully get the band out next week. He does it in two separate operations. He says the scar tissue with the band can be tricky to deal with (to revise in the same operation to the new surgery)but that it resolves on a month or two. So, with a little luck, I will get my operation in may or june. Please keep your fingers crossed for me that Anthem Blue Cross Blue Shield will cover it. If you have gotten this far, thanks! Lisa