njlimmer

I am scheduled for March 1st. So excited and a bundle of nerves all at the same time.

I get the frustration, but I think this is pretty normal - or at least mine was very similar. They verified that my insurance covered it before I went in for my appointment, but after my consultation, they suggested that I call my insurance for clarification and that really helped. Your insurance company will have to explain the out of pocket stuff to you, but basically the numbers change and they can't give you a hard and fast figure NOW because things change.
For example, I had my EGD (endoscope) on Jan. 8th and I had to pay almost $850. My deductible is $800. When the doctor's office called me with my surgical info, they told me a number that'd I'd have to pay on a certain date. When I mentioned what I had paid for my EGD, their number changed because it takes FOREVER for insurance to get stuff in and processed and they didn't have the payment that I'd already made for the EGD.
So, if they quote you a number today... and life happens... it could be a different number by the time you're actually ready for the procedure. Also, they don't want to quote you XYZ and have things change to ABC and that cause more problems down the line.
I feel your frustration and it is confusing, but I don't think it's completely abnormal.

I'm 6 weeks post op and no matter what I eat, I feel ill. I hate food now. I never want to eat anymore, I'm barely able to eat anything.When I eat, it hurts. When I drink (sip!), it hurts. I get dry heaves almost daily. I'm having a hard time meeting my macros, my meds make me feel sick too. Haven't met with my (b***h) doctor yet- she has the worst bedside manner I have EVER encountered! I do not feel confident or comfortable talking to her at all about my issues. I've even tried switching to another program but that "just isn't done." I hope this passes, I feel so hopeless rn.

You know I've researched for over a year, spent countless night watching other people's journey, taking class and I still feel as if I fell short. For the first time since my surgery (Jan 22nd) I broke completely down, I knew it was going to be hard but you never realize how truly difficult it is until you go through it. Tomorrow is my birthday and I've been a bit depressed so I got my favorite Indian dish pureed and just couldn't...it made me cry. The struggle of eating and constantly feeling it go to my stomach or swallowing to much air and getting gas, having to count and count and count. Don't forget the Protein, don't forget to hydrate, or your Vitamins. I want to do everything right but I feel like I'm coming up short. I can't stand the taste of any food or Protein Drink, trying to hydrate is a b***h because I keep thinking I'm going slow and end up getting bad cramps from it....and those monstrous bricks they call vitamins make me gag or vomit ugh. I know it'll get better I know this will pass but being in the present and feeling like I'm getting no where is killing me. And the mood swings don't make it any better...I'm incredibly sad or angry all the time. I don't regret this at all I just wish I could make the progress I'm supposed to be making and enjoy it. I've lost 25 pounds since surgery so I'm grateful for that, its just such a long and lonely process since no one around me understands. They say they do but they really don't.... just needed to vent. Thanks for listening.
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So, I haven't really told many people about my surgery. A few close friends know, my mom, and my sister. I tell my mom everything so she knows, but out of my few close friends, only one was really supportive--everyone else was a bit hesitant. They all struggle with their weight, including my sister. So I don't like sharing my victories as they all start feeling bad about themselves. But today was huge and I want to share with someone other than my amazing and supportive mom. I laid down today to do sit-ups and I could actually see and feel my ribs starting to show through. I thought it was too good to be true so I videoed myself and lo and behold, I could see them quite prominently. I haven't seen them since 2015/2016. I am so excited! I can't see them standing up, obviously, but man was it a surprise laying down. Just really happy! I also tried on a shirt that was too tight before and now it is baggy.
Anyway, that was my NSV. Thanks for listening!

Yes Unfortunately.

I wish that there was just a set price for a procedure but it *seems* that when dealing with insurance companies (vs self pay) there is a range or a maximum Doctors and Hospitals will bill insurance companies.
If you were to pay for surgery completely out of pocket they *probably* could give you a better estimate mostly because your are billed upfront and sometimes after if there was an unexpected variable.
If you have access to any of your health insurance bills & documents (especially the Explanation of Benefits - EOB) check your last few appointments or procedures to see what was billed to your insurance, what the insurance actually paid and the patient responsibility amount (what you had to pay). That might help you understand your particular coverage a little better.
Also definitely call your insurance company to verify coverage of the procedure and ask for it in writing.
I know there are many people on this forum in the healthcare or Insurance field that may have even better explanations.
I hope that helps a little ❤️

I absolutely get it. If my insurance didn't cover it, I wouldn't be getting it either, but based on what they DID tell you, it looks like as long as everything is in network, your max out of pocket is 2750. The way my insurance explained it was that you pay the deductible first. Then everything after the deductible is 80/20 with them paying 80% and me paying 20% so if the bill was 100, I'd pay 20 and they'd pay 80. That works all the way up until the 2750. Once you've paid 2750, then insurance should cover it 100% unless it's out of network - so if the bill is 100,000 - you should only have to pay 2750. Since the medical folks don't want to tell you too much, you're best bet is to call your insurance and tell them you want to get the surgery, ask what's covered and what's not, and are there any expectations in terms of classes, etc... That will give you more info in terms of the $$$ than the doc's office will.

I absolutely get it. If my insurance didn't cover it, I wouldn't be getting it either, but based on what they DID tell you, it looks like as long as everything is in network, your max out of pocket is 2750. The way my insurance explained it was that you pay the deductible first. Then everything after the deductible is 80/20 with them paying 80% and me paying 20% so if the bill was 100, I'd pay 20 and they'd pay 80. That works all the way up until the 2750. Once you've paid 2750, then insurance should cover it 100% unless it's out of network - so if the bill is 100,000 - you should only have to pay 2750. Since the medical folks don't want to tell you too much, you're best bet is to call your insurance and tell them you want to get the surgery, ask what's covered and what's not, and are there any expectations in terms of classes, etc... That will give you more info in terms of the $$$ than the doc's office will.

I get the frustration, but I think this is pretty normal - or at least mine was very similar. They verified that my insurance covered it before I went in for my appointment, but after my consultation, they suggested that I call my insurance for clarification and that really helped. Your insurance company will have to explain the out of pocket stuff to you, but basically the numbers change and they can't give you a hard and fast figure NOW because things change.
For example, I had my EGD (endoscope) on Jan. 8th and I had to pay almost $850. My deductible is $800. When the doctor's office called me with my surgical info, they told me a number that'd I'd have to pay on a certain date. When I mentioned what I had paid for my EGD, their number changed because it takes FOREVER for insurance to get stuff in and processed and they didn't have the payment that I'd already made for the EGD.
So, if they quote you a number today... and life happens... it could be a different number by the time you're actually ready for the procedure. Also, they don't want to quote you XYZ and have things change to ABC and that cause more problems down the line.
I feel your frustration and it is confusing, but I don't think it's completely abnormal.

I totally get not giving me an exact number, but I would at least like to know if the insurance covers the surgery at all before I begin. And what, if anything else. Problem is I simply cannot go into this blindly not knowing what sort of financial responsibilities I may have along the way or even in the end. I mean, the numbers will be a HUGE deciding factor for me, sadly, because it has to be. As much as I MAY NEED IT, if I can't afford it I simply cannot go through with it. Thanks so much for your input.

YES! Exactly. 10 pounds allows for a little extra room in my socks!

Started at 310 in October 2020. I've lost 35lbs on my own so a current weight of 275. I'm just now seeing a difference in some of my clothes. My surgery is scheduled for 3/3/21 so I start my pre-op on 2/17. Excited but nervous too!! The original post all those years ago asked if there were things that others might not understand. I think not seeing a difference until there's significant weight loss is one of those. I have friends who if they lose 10 pounds they're in a whole other size.

I announced on Facebook today that I am planning on having gastric bypass. I am an honest person, and transparent as far as my thoughts and feelings, so I wanted everyone to know what was happening before I started losing massive amounts of weight. Everyone has been very supportive in their responses thus far but it has left me feeling exposed and vulnerable. Bring on the anxiety.
On a positive note, I've lost 2 more pounds and have gone down 2 pant sizes since starting this journey. [emoji1373]

I started at 629 lbs (per the bed scale at the hospital; I was on a ventilator for 8 days with what, in retrospect, was probably Covid-19) on 12/26/2019.

I weighed 501 lbs at my consultation with the surgeon on August 14th, and 460 lbs on my surgery date of 10/21/2020, and last week when I weighed myself I weighed 428 lbs.

So to date, I have lost around 200 lbs. It's so much, but I still have so much left to go. I feel so much better, and I can do so many more things, but I can't wait to see what the future holds. I know I can do this. I have proven to myself time and again that I can.

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I had the sleeve and I didn’t have a drain either. Don’t think it’s as common to have to have one placed.

Haven’t been able to wear this top from the day I got it so super excited!!

Haven’t been able to wear this top from the day I got it so super excited!!

Haven’t been able to wear this top from the day I got it so super excited!!

Congratulations 🎉

Haven’t been able to wear this top from the day I got it so super excited!!

Haven’t been able to wear this top from the day I got it so super excited!!

I had one post surgery for about 24 hours. I’m really sorry to report it hurt quite a bit when they took it out but I may just have been being a wuss about it. They removed it shortly before I left the hospital the day after surgery.

I’ve been researching wls for years and am finally scheduled to get a sleeve next month. Today I had a checkup with my PCP and mentioned I was having the surgery and he told me I absolutely shouldn’t. He said that while I would lose weight initially my stomach would stretch back and undo the surgery because I would keep eating how I’m eating (I actually eat very healthy, he has no idea about my diet, he was just guessing because I’m obese). I said well yeah, that’s why I’d adjust and start eating smaller portion sizes etc., and he said “If you think you can do that, why aren’t you doing that already?” Well because I’ve done that before and my weight doesn’t change no matter what I eat so I might as well eat what I want instead of starving myself all the time and slowing my metabolism even more. He then continued to talk about how if I would eat more vegetables and walk for 30 minutes 5 days a week my weight would fall right off, even though I trained for and completed a triathlon last year without dropping a single pound and, like I said before, actually already eat a lot of vegetables. He finished by listing all of the possible complications of the surgery as if they were all guaranteed to happen to me and strongly suggested that he was going to drop me as a patient if I got the surgery: “If you decide to do it anyway, I’m not picking up the pieces of that mess.”

I’m still getting the surgery, and I’m used to this attitude from family and coworkers but this was upsetting because I had expected my doctor to be more knowledgeable about how weight loss actually works. Guess I’ll have to find a new PCP. Thanks for listening to my rant lol

One of the doctors in my program had a mantra that said: Start living now like you are post surgery.

I'd heard it before but never tried it, but switching to a small plate has made a huge difference! I've also tried to work on taking small bites, putting the fork down between bites, and chewing a ton! I figure every habit I can start BEFORE will help me after.