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Even though my insurance won't pay for the sleeve :(, it will still pay for all the pre-op tests that USA docs usually require before sleeve surgery. SO, I got the list of what my local one requires and am getting them done even though the Mexican surgeons don't require them.

These include:

Upper G.I (i think this is the endoscopy test....not sure)

Ultrasound of liver

Cardio test (not sure what they do, I think an EKG)

Pulmonary test (again not sure, will update post test)

sleep apnea test

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That is great! I plan on doing the same tests as well before heading to Tijuana.

I am getting my surgery for the Sleeve in November.

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Hey congratulations. Did you set a definite date and send in your deposit? I am looking for the first week of August. I don't know why I put this topic. I guess I just wanted to put a list so people know what the 'usual' tests are.

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Oh yes I most certainly do have the date set. I set it for Aug 5 nearly 3 months ago when I sent in my deposit. I wanted to set my date so I could buy my airline

ticket and arrange my days off at work Most people don't plan so far ahead but my situation to was that I don't have the $4500 cash for the surgery yet. I am still saving up.

I've researched my doctor a lot and continue to after sending in my deposit learning more about him with all the stories I find out about his current patients. I especially have learned SO much on Facebook on the Sleeve Gastrectomy and Weight Loss Surgery groups.

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Hey, I am looking at the first week of August too. I am looking at Dr. Garcia, Dr. Illan and Dr. Quionones now. I have air miles but I want to get the tickets right away so I can be sure to get the seats I want. There is another lady on here that is also going that week. I think we will all be staying at the Marriott. I want to go a few days early (maybe) and hang out at the beach some. I am not sure thought because the all liquid diet might just make it miserable.

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Just curious, but doesn't your insurance company require a REASON for having all those tests before they will approve to pay for them? Doctors have to submit billing and diagnostic codes to the insurance company. I ask because only some of my routine post op bloodwork will be covered by insurance. My PCP can submit certain tests under a wellness check, but he can't really explain the specialty Vitamin deficiency tests without mentioning the surgery or flat out lying about a differential.

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But why would we have to lie about the surgery? My pcp is ordering the tests for preparation for bariatric surgery. I don't see why the insurance company would care if I have surgery or not. If blood work is needed, it is needed. I will double check though. Even if they would refuse for bariatric- I have plenty of non - bariatric reasons for getting the tests done.

Edited by Travelmego

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That's great that you can get these tests paid for. Does that mean your insurance does cover WLS? And also great your PCP is on board with your decision. Unfortunately my insurance (Blueshield) excludes WLS, including any type of weight Loss treatment, counseling or complications of WLS, so any reference to it on claim submissions would result in the claim being denied. I went through the same thing with my fecal transplant, too. Since they wouldn't cover the fecal transplant itself (because they consider it experimental) they also wouldn't cover the bloodwork, stool tests, or colonoscopy that were required before the transplant. These things would have been paid for if they were done for an "approved" procedure.

Hope you get all A's!

Edited by Kindle

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But why would we have to lie about the surgery? My pcp is ordering the tests for preparation for bariatric surgery. I don't see why the insurance company would care if I have surgery or not. If blood work is needed, it is needed. I will double check though. Even if they would refuse for bariatric- I have plenty of non - bariatric reasons for getting the tests done.

I am self-pay too, my insurance excludes bariatric surgery, to get your tests paid for the Doctors code the comorbidities, like heart burn, high blood pressure, blood work results, etc. sleep tests are based upon visuals like your neck size and being tired, they find a way and none of it is unethical because these test are not WLS specific.

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Do I need to have my doctor change the reason for the tests? I had him put for bariatric surgery on the referral. However, I can surely need these tests just in and of themselves for diabetes and being overweight. My insurance does cover bariatric bypass but not the sleeve. However, I don't want the bypass hence Mexico. Also, it is a pain trying to get accepted for the surgery anyway.

If he already did the referral for bariatric, can I go and change it? Or will they be like, 'nice try but too late you already said bariatric'?

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Thanks for posting this topic. I am now thinking maybe I should have a couple of tests as well. One girl on another forum states that an ulcer was found (which delayed her surgery) during an endoscopy, so it's probably a good idea to have some of these tests before I head in for surgery next month.

Good point about the insurance too. Bariatric surgery is an exclusion in my insurance policy, so I'm not sure how that would go as far as Humana covering the tests. I will speak to my doctor about it.

C.

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candy - i would say it can't hurt, might help.

Darn it! I have a feeling I need to call the referral lady tomorrow and ask her to send them AGAIN but coded for like just the regular stuff. My insurance pays for gastric bypass but with it being a pre-approval thing - I just have this feeling that @@Kindle and @@SnohoGal98296 are right and I need to have it redone. She is going to hate me lol.

Edited by Travelmego

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I'm sure your doctor and his billing department know what your insurance does and doesn't cover....more so than I do. You would have to have all those tests and submit results to be approved for the bariatric surgery they do cover, so it's probably OK. My situation is completely different since my insurance excludes all WLS, so obviously they wouldn't pay for any tests related to WLS.

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Hmm...I will call and ask. They do cover wls BUT it has to be pre-approved (as probably all do). I am not sure they will cover it without having the whole thing pre-approved. I will call and ask today.

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I am going to go out on a limb and say that the cost @@Travelmego insurance would want pre-approval for is the WLS, not the pre-op tests. In fact I bet they are betting that something in the pre-op tests will exclude the surgery - because they are Dr. Evil like that :-D

Good Luck and Best Wishes Travelmego!

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
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