Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Have to leave you all



Recommended Posts

Hello Friends. I am sorry to say that my insurance co. turned me down for the Sleeve.....I am not heavy enough!!! Go figure. A real bummer, I was so excited. They are going to talk my surgeon tomorrow to get me changed over to gastric bypass which is what I initially thought I was getting. Please say a prayer for me that I get this one approved

Thanks to all and many blessings Judy

Share this post


Link to post
Share on other sites

Good luck Judy....weird decision making on their part, but sometimes the world works in strange ways!

Hope it all goes right for you.

Share this post


Link to post
Share on other sites

Hi Judy,

I'm so sorry to hear that news. I'm just a little baffled too - I would think they would reserve GB or any kind of malabsorptive procedure for those that have much more to lose. Oh well, though I'm not a Dr. either.

Regardless I wish you well and that you make your goal and on the way to a healthier you!!! That's what this is all about - :)

Share this post


Link to post
Share on other sites

Reading between the lines and based on what other information I've read I would hazard a guess that the insurance company considers the VSG as a PRECURSOR to the bypass. It was originally used to allow morbidly obese patients a safer alternative to bypass and allow them to loose enough weight to be able to safely get a bypass. It hasn't been till recently that a VSG alone has been considered a total solution.

My guess is they don't want to pay for a VSG first then a bypass later.

mspuddytat , have you considered a self pay option? It may actually be a cheaper way to go.

Share this post


Link to post
Share on other sites

I'm sorry to hear that :) good luck on your journey.

i ran into a girl i know the other day and she was shocked when i said i had the sleeve.

she just had the bypass and she said her hospital was more strict with the sleeve than the bypass.

odd i thought :)

Share this post


Link to post
Share on other sites

We wish you the best! Still stop by and let us know how you are doing!

Share this post


Link to post
Share on other sites

Best wishes ! ! ! That's pretty insane considering bypass is far more drastic for weight loss, and almost double the cost as the sleeve procedure. Not to mention the long term complications insurance companies are having to pay for due to RNY complications. I do wish you the best, but before you go under the knife, make sure your insurance company denied you for the correct reasons.

Make sure you get a denial letter from your insurance company with that being the reason, and that it isn't something that your surgeon's office isn't making for you.

Share this post


Link to post
Share on other sites

Hello Friends. I am sorry to say that my insurance co. turned me down for the Sleeve.....I am not heavy enough!!! Go figure. A real bummer, I was so excited. They are going to talk my surgeon tomorrow to get me changed over to gastric bypass which is what I initially thought I was getting. Please say a prayer for me that I get this one approved

Thanks to all and many blessings Judy

At first I thought I would give in too when my insurance denied me due to it being an "experimental" surgery. I really considered the lap-band and the bypass. I did my research, then I wrote a personal letter explaining all the reasons that the sleeve was best for me. I backed it with current research about the loss rates, recovery rates and all that for the sleeve. I sent it in with a letter from my surgeon for appeal and I WON! I got the sleeve. I hope that you are doing this because you want to, not because you are just settling. It is worth the time and effort invested to find and get what you really want. Best of luck to you.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
      I live on the island of Oʻahu and spend a lot of time in the water- for exercise, for play,  and for spiritual & mental health. The day I had my month out appointment with my surgeon, I packed all my gear in my truck, anticipating his permission to get back in the ocean. The minute I walked out of that hospital I drove straight to the shore and got in that water. Hallelujah! My appointment was at 10 am. I didn't get home until after 5 pm. 
      I'm down 31 pounds since the day of surgery and 47 since my pre-op diet began, with that typical week long stall occurring at three weeks. I'm really starting to see some changes lately- some of my clothing is too big, some fits again. The most drastic changes I notice however are in my face. I've also noticed my endurance and flexibility increasing. I was really starting to be held up physically, and I'm so grateful that I'm seeing that turn around in such short order. 
      My general disposition lately is hopeful and motivated. The only thing that bugs me on a daily basis still is the way those supplements make my house smell. So stink! But I just bought a smell proof bag online that other people use to put their pot in. My house doesn't stink anymore. 
       
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×