Sam.J.S.

Hey everyone!
Thank you for all of the advice with insurance, but I'm all set on that front! I actually called my insurance prior to making this post and made sure the surgery was covered, asked what my out-of-pocket cost would be, and if I needed a referral or not (and I did, which is why I made this post )
In my previous comment, I just meant I will leave the insurance paperwork to the doctor's team! (Though I do plan to be a burden and double/triple check that all referrals are in, everything is on-track, etc.)
Also, minor update: my PCP gave me the referral! She was so supportive of my decision and made me feel even more excited about this opportunity. Now, I am waiting to book a consult with the surgeon. I can't wait!
Thanks again for all your advice ❤️

Hey everyone!
Thank you for all of the advice with insurance, but I'm all set on that front! I actually called my insurance prior to making this post and made sure the surgery was covered, asked what my out-of-pocket cost would be, and if I needed a referral or not (and I did, which is why I made this post )
In my previous comment, I just meant I will leave the insurance paperwork to the doctor's team! (Though I do plan to be a burden and double/triple check that all referrals are in, everything is on-track, etc.)
Also, minor update: my PCP gave me the referral! She was so supportive of my decision and made me feel even more excited about this opportunity. Now, I am waiting to book a consult with the surgeon. I can't wait!
Thanks again for all your advice ❤️

Hey everyone!
Thank you for all of the advice with insurance, but I'm all set on that front! I actually called my insurance prior to making this post and made sure the surgery was covered, asked what my out-of-pocket cost would be, and if I needed a referral or not (and I did, which is why I made this post )
In my previous comment, I just meant I will leave the insurance paperwork to the doctor's team! (Though I do plan to be a burden and double/triple check that all referrals are in, everything is on-track, etc.)
Also, minor update: my PCP gave me the referral! She was so supportive of my decision and made me feel even more excited about this opportunity. Now, I am waiting to book a consult with the surgeon. I can't wait!
Thanks again for all your advice ❤️

Hey everyone!
Thank you for all of the advice with insurance, but I'm all set on that front! I actually called my insurance prior to making this post and made sure the surgery was covered, asked what my out-of-pocket cost would be, and if I needed a referral or not (and I did, which is why I made this post )
In my previous comment, I just meant I will leave the insurance paperwork to the doctor's team! (Though I do plan to be a burden and double/triple check that all referrals are in, everything is on-track, etc.)
Also, minor update: my PCP gave me the referral! She was so supportive of my decision and made me feel even more excited about this opportunity. Now, I am waiting to book a consult with the surgeon. I can't wait!
Thanks again for all your advice ❤️

Some helpful hints. You will be INCREDIBLY thirsty/ dehydrated post - surgery. Bring Biotene toothpaste and mouth wash. Swish as much water as you can as soon as you can reach a sink. You may not be able to swallow fluids just yet. And your mouth will THANK you! You can get at Amazon/ Walmart/ Target.

BariWise chicken Bouillon- lifesaver - Amazon. Clear Liquid- it tastes good and has 15g of protein. Amazon - Amazing.

****PILL GRINDER (not cutter) - looks like pepper grinder to actually GRIND your pills so much easier to swallow! - Amazon.

Ask the hospital for the 30 cc cups - they’re 1 ounces and you can pour your protein shake and liquid clears to keep measurements .

**** DO NOT be afraid to ask for pain medication (this was a mistake I made). I acted tough. Ask ask ask for nausea meds - lifesaver. No vomiting.

Women - plan on wearing a sports bra that doesn’t touch your top incision and cotton underwear that does not touch your bottom incision. Wear a loose cotton dress to go home in and for recovery. Amazon has a lot of different ones (with pockets). You can lounge in them. Walk around the neighborhood and go out with nice sandals/slip on shoes or flip flops.

Amazon also has long roomy comfy sleep shirts - great for lounging and letting your incisions breathe.

BariWise hot chocolate- 15grams of protein and considered a clear. Add sugar free syrup ( can get a bottle at Home goods for under $5) for a treat. Cinnamon sticks and peppermint tea help with nausea.

Throw a cinnamon stick in your decaf hot tea of choice (or hot chocolate).

Take a small walk when comfortable even if it’s just around the house when you are waiting the 30 minutes before or after your protein.

If you have a gentle dig - take them for a walk (although the first few days I couldn’t because of the bending to pick up poop). My neighbor offered to walk the dog for a few days.

Enlist help - people like to help.

I was sent home with liquid pain med - keep on schedule and Prilosec capsules. I was instructed to open up. Toss the beads back and follow with chaser - amazing - helped with stomach pain.

Also sent home with anti- nausea under tongue melts - AMAZING.

If you have headaches/ menstrual cramps - I recommend Hylands brand / melts under tongue (Amazon).

Hope this helps! Wish me a great recovery!

Best, Christina

I’m getting a sleeve and haven’t had surgery yet but when I put in for leave at work I told my boss and coworkers that I was having part of my stomach removed due to ulcers (not entirely a lie, I do need it for that reason as well). I joked about how “at least I’ll lose weight as a side effect” and everyone was supportive and called me “lucky” to be losing weight as a side effect of a “legitimate medical procedure”. And then they all trash talked getting a bariatric procedure solely for weight loss ?. If you don’t feel comfortable sharing with anyone you certainly don’t have to, but if you want to maybe stretching the truth a bit will help it be easier to swallow for others. It’s so sad that weight loss procedures are shamed. We’re looked down on for being fat and then looked down on for doing the things we have to do to lose weight. It’s not fair

The insurance company is bound by a contract, either between you and them for direct pay, or more likely between an employer and them to provide certain types of care. There’s no risk in calling them, there’s nothing to inadvertently agree to. All they can do is provide information on contracted plan benefits.

In the end you need to take responsibility for your own finances and you should confirm everything with insurance yourself. I work with both health care and insurance and it’s vital to have a personal understanding of your plan benefits and how it will impact you. When I called I asked

1. Is bariatric surgery covered? Is there a prior authorization requirement? Can you share with me the page of the plan document that outlines these prior authorization requirements?
2. Are there requirements to see a surgeon/hospital within the plan network, or certain providers in order to receive coverage?
3. Is this subject to the deductible and coinsurance or are there special provisions for this coverage?

Hopefully your surgeons office will help you with this, but I never recommend being passive and trusting someone else to do something when there’s tens of thousands of (your!) dollars on the line.

Good luck! That is so exciting

My doctor was delighted I brought it up. He loved the idea and said he had several patients in his practice who had terrific results. He had an excellent recommendation for a Bariatric program, too.

I would also call your insurance company to find out what they cover and what their requirements are. Some insurance companies require documentation from your doctor that you tried other weight loss techniques. I would think your primary care doctor would be supportive but even if he or she isn't, you will want the records of the history of your weight. Good luck!

First step is to tell your PCP that you would like to pursue WLS and ask them if they will give you a referral. If they don't, find another doctor who will.
From there your referring doctor and insurance will tell you what you need to do (different insurance companies will have different requirements).
This is exactly what I did with my PCP. I told him I want WLS, he said OK, and would submit his referral. Note, however, that I am in Canada, so its a little different, as WLS is covered by provincial insurance for those who qualify, but the process is essentially the same, just different institutional providers.

I would call your insurance company. They will tell you if it is included in your coverage. Doing this, will keep you from wasting time, and worry. Excellent place to start. You pay them, and they are there to help you.

...and that's cool too.
To the OP, do whatever you feel comfortable with...take whatever suggestions YOU feel is in your best interest, and leave the rest.
Good Luck! ❤️

This exactly. The more informed you are - the better off you are. The surgeons will make you sign "In the event my insurance does not cover a procedure, I agree to pay". The surgeons office is a great tool and yes they will assist in many ways but IMO it is always better to be informed.

Keeping informed/copied is one thing, but IMO I would not "get involved" with direct communications with the insurance company unless needed. You may inadvertently agree to something without realizing its ramifications. Let the medical team handle the direct correspondence. They know this industry; you don't. The last thing you want is for the insurance company to come back after the fact and say "on date xx-xx-xxxx you agreed..." when you had no idea you were agreeing to anything.
The language/nomenclature of both medicine and insurance are jargonistic and complex. Getting involved unnecessarily could either delay the process or at worst upset the apple cart.
The internal billing, fees, and writeoffs for the procedure and all the lead-up and after-care will contain a zillion transactional amounts, some likely not resolved until months after the procedure. Getting involved and asking "what is this line item?", "what does this term mean?", "why is that there?" is likely to not be productive.
At the end of the day, what matters are your personal out-of-pocket costs and obligations, and it is fair to ask the medical team to keep you apprised of any decisions that change those personal costs, but to get involved in the transactional details is going to be an exercise in futility... for all parties concerned.

Just a suggestion: perhaps you may want to get involved in the details just so you are informed? The payment/coverage contract is between you and your insurance, not between you and the doc. Your surgeon is not held accountable for any promises they make you regarding coverage and reimbursements, if in the potential case of misunderstanding between surgeon and insurance. Your insurance will not accept "well, that's what my surgeon told me".