I have been watching this thread and researching for probably a month now and decided to speak to my dr about the gastric sleeve! I do have a BMI of over 40 and no other Problems so I thought I should be a good candidate for the surgery... Well today was the day I thought I would get some answers regarding insurance and requirements and atleast get the ball rolling .... I was totally wrong !!! My Dr. Was the least supportive she didn't have much to say other than usually insurances want to see 10 percent of your weight lost and maintained for a year before they will even consider you ... This was just so discouraging because when I asked her about my insurance and what they require I was just told to call them and find out... I feel like I am starting the process alone!! Has anyone had this happen? I just want to get a start to it , I know surgery won't happen over night I just felt like she was so unsupportive !!

I have been watching this thread and researching for probably a month now and decided to speak to my dr about the gastric sleeve! I do have a BMI of over 40 and no other Problems so I thought I should be a good candidate for the surgery... Well today was the day I thought I would get some answers regarding insurance and requirements and atleast get the ball rolling .... I was totally wrong !!! My Dr. Was the least supportive she didn't have much to say other than usually insurances want to see 10 percent of your weight lost and maintained for a year before they will even consider you ... This was just so discouraging because when I asked her about my insurance and what they require I was just told to call them and find out... I feel like I am starting the process alone!! Has anyone had this happen? I just want to get a start to it ' date=' I know surgery won't happen over night I just felt like she was so unsupportive !![/quote']

I told my PCP that I needed help w weigh loss and that is like a recommendation to a place that specialized in obesity treatment. He wrote the referral and since then all I have worked with is with obesity center. Don't be afraid to switch doctors. Its your health and it needs to be taken seriously.

The battle I had with my weight was life long and mine alone. I didn't start by going to my general doc, I started with researching and finding a good surgeon first. The team of folks at my bariatric center helped and supported me with every step.

The first step was attending a group info session and then I made a follow up appointment with the surgeon I picked. At that follow up appointment I asked him to refer me to a general doc for follow up. I did that b/c I assumed any doc he would send me to would be supportive of the surgery and worked well with his team. That certainly was the case.

The bariatric center did everything insurance wise! I did call my insurance company first to find out the general benefits but nothing else after that. The center just gave me instructions of what to do next - which was see a ton of different doctors and take a bunch of tests but it was all worth it. It really got me in the right mindset to make it all work.

TLDR; find a good surgery/bariatric center and they will be all the support you need!

Good LUck!

If I could have successfully lost a bunch of weight, I wouldn't have needed the surgery.

I am just starting the process as well. I know some, not a ton, so I will give you only what I have experienced and maybe someone that is more knowledgeable than myself will have more info. I have a private insurance and required a referral from my PCP to my local Weight Management Program (I'm in Massachusetts). I actually did have to call my insurance myself to find out what their requirements were and what would be/wouldn't be covered, so in that regard your doctor was correct (you really should call them and find out what their requirements are as most insurances have different requirements from what I am learning). I have never heard of the "loose 10% of body wt and maintain" policy but that may just be because my insurance didn't require that. From what I am hearing during support groups I have attended and meeting w/ my nutritionist, it seems as if your BMI alone should qualify you. Well with all that said, if I were you, I would start by calling your insurance and see if you need a referral or not. Do you have a local hospital that you tend to use?? Do they have a weight management program?? Once you have this info I would present it to your PCP and ask for the referral (if needed). Again, I am new at this too but this is what I have learned so far. Hope some of the info is helpful and Good Luck!!!

Hi Lauren,

I can feel for you. I had researched for some time then when I had decided the sleeve was what i needed to do for me, found out my insurance excluded WLS in any way, shape or form. Bam!

I am lucky to live in a place where we apparently have tons of fatties as the Dallas/Fort Worth area is full to top notch centers of excellence surgeons that do the sleeve for a reasonable cash price. I did it and it was the best thing I did for myself in my 50's. Being self pay puts you to the front of the line. No hoops. For me, it was so worth it. My surgeon is at a center of excellence and in all honesty the cash I put out was a bargain at twice the price.The $12,200 has been the best money I have spent on my health. My live has changed for the amazing in the last 7 months.

Thank you all so much for the advice!! I will definitely be making some phone calls tomorrow! Also, I forgoT to mention my Dr prescribed me some kind of weight loss medication that she will only prescribe for 3 months but couldn't tell me side effects or anything like that she told me to look on their website... So I am not sure about it !!

The 10% weightloss that I have heard of is after you get approved in a program to have surgery/ That is only to help shrink the liver and make the fat easier to work through. I am sorry your doctor isnt supportive of you and what you want to accomplish for yourself. The first thing I did was contact my insurance and ask them which centers they will accept my surgery from. Then I went to the informational and the center told me everything I needed to do before I had the surgery. I did those things and we picked a date. Good luck.

Just some suggestions...look for doctor that works with a "center of excellence" credential.

If you didn't get good vibes the doc you met. Find another one....there is tons of information on the forums rom actual patients - pre and post from you area.

Just search for them. It's nice to hear from actual people.

I wouldn't want someone who rude cutting me open.

Meet at least another doctor...you records will transfer....I wish you lots of luck. It's work but you'll find the right doc for you,

Carmen

Thank you all so much for the advice!! I will definitely be making some phone calls tomorrow! Also' date=' I forgoT to mention my Dr prescribed me some kind of weight loss medication that she will only prescribe for 3 months but couldn't tell me side effects or anything like that she told me to look on their website... So I am not sure about it !![/quote']

My guess is she prescribed something like phentermine - which does have side effects. If it is that I can share it left me w dry mouth and some what jittery. Be sure to take in the morning so ur able to sleep at night and try to avoid caffeine while taking it.

Thank you all so much for the advice!! I will definitely be making some phone calls tomorrow! Also' date=' I forgoT to mention my Dr prescribed me some kind of weight loss medication that she will only prescribe for 3 months but couldn't tell me side effects or anything like that she told me to look on their website... So I am not sure about it !![/quote']

My experience was pretty much the same left with a diet pill prescription but my PCP did admit she knew little about the process so I ended up making calls that might be the case with your doctor. Doctors don't always want to come out and say they just don't know. However, once you bring the info to them ( referrals needed, etc) they are usually ok with signing off.

The process in America is sooo different to the process here in Australia, I saw my GP, he was supportive and had a referral to a specialist he highly recommended straight away for me, 3 weeks later I saw my specialist & was booked in for surgery on the same day which was 5 weeks away.. And my private health covers all hospital stay costs, all I had to pay was the excess fee of $500.. It's awful that they make it so difficult and make people who need the help wait so long

I started my WLS journey without even consulting my primary doctor. Luckily, I don't have to have anything from him. Like others have said, I would just find a bariatric surgeon and go from there. Good luck!

I too started the process without my PCP. If the prescription was for phentramine--I have personal experience with it. I went to a "weight loss doctor" who gave me phentramine for almost a year. I lost 60 pounds and then had to go on high blood pressure medication!!!!!!! Beliveve me, as soon as I stopped taking what is basically legal speed, that weight came back faster than a speeding racecar.

I'm waiting to see if my insurance will approve my surgery. What concerns me is I don't have comorbities like diabeties or high blood pressure. However, my knees are so bad they need to be replaced, (too young) and I have a compression fracture and herniated disc in my spine. I just want to be able to wake up, walk and move without pain.

I hope you will be able to do what you need to do to get there and I wish you well on this journey.

Thank you to everyone who replied to this thread with their insights! I was able to talk to my insurance it looks like they have the 6 month documented weight loss time period before the surgery it was not a year like the DR had mentioned ... Also looked into my prescription of the weight loss pills that my Dr prescribed me it is called Qysmia which has phentermine as well Topiramate,which is used to treat seizures with apparently ... The side effects are kinda scary mentions suicidal thoughts , and even seizures if you come off the medication too quickly so I have not gotten the prescription filled ...

So with that being said I have another appointment on Monday but with a different doctor from my medical group just to get a second opinion on the medication and more importantly the surgery! I would love any advice anyone can give me with talking to the DR about the surgery!! With my BMI alone it shouldn't be a problem I am just nervous!!! Thank you !!

Thank you to everyone who replied to this thread with their insights! I was able to talk to my insurance it looks like they have the 6 month documented weight loss time period before the surgery it was not a year like the DR had mentioned ... Also looked into my prescription of the weight loss pills that my Dr prescribed me it is called Qysmia which has phentermine as well Topiramate' date='which is used to treat seizures with apparently ... The side effects are kinda scary mentions suicidal thoughts , and even seizures if you come off the medication too quickly so I have not gotten the prescription filled ...

So with that being said I have another appointment on Monday but with a different doctor from my medical group just to get a second opinion on the medication and more importantly the surgery! I would love any advice anyone can give me with talking to the DR about the surgery!! With my BMI alone it shouldn't be a problem I am just nervous!!! Thank you !![/quote']

You moving into he right place. I am so glad that you chose to seek a second opinion. Doctors are people and some people just can't understand the perspective of someone who has been struggling like we do. I wish you all the best we are here for you keep us posted