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The sum of all fears



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I think you should ask them for a discount. I had to pay for mine and it was worth every penny but I knew that going into it.

Sorry that sucks and not fair.

~LA

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I don't want to be the naysayer here, but when it comes to our health and our health care we need to be our own advocates. You can't listen to what Dr.'s offices or staff have to say. You need to call your insurance company and find out directly what is covered, what is not covered, ask them a million and one or more questions you are paying them for goodness sake and it is their job to provide you with the answers to ALL your questions about your health care coverage and plan.

it stinks to have gone through all those tests to find out that your coverage excludes this type of surgery but don't give up, and don't look at it as an all for nothing. You found out some very important things about your health that will help you in the long run to be healthier. In the mean time call your insurance company and ask them why the preclude this type of surgery, and if there is an option to have it included. Is it because of the employer not opting into a part of the plan? Are there any other options for Weight Management that they suggest under the plan? If it is an employer exclusion is it possible to speak with your HR staff about it and see if an exception might be made?

Don't give up on yourself no matter what. Keep the momentum going...!!

My clinic hands out a bright pink sheet with all the questions to ask the insurance company. It states that it is your responsibility to know. But they also verify it.

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When I filled out the application it said in big black bold letters it was my requirement to know what my insurance would cover

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How discouraging. I'm so sorry you are in this situation, but please don't give up all hope. What about tax returns? Do you get any money back after taxes? I usually don't, but 2 years ago we did and I used that to pay off 1/2 of my expenses as I was all cash pay. What about a small loan? It would be worth it to have the surgery done and know that with each of those payments, you are improving your overall health and mental well being!

Again, please don't give up. There are ways out there, we just have to keep searching to find them. So frustrating that insurances don't cover this when in the long run, it cuts the health issues that they would be paying out for, drastically! Good luck!!

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And here's one more idea: maybe Obamacare can step in.....how about finding out about secondary insurance, or using your state's insurance (Obamacare), that may cover you? One thing I have learned in my life is to NEVER NEVER NEVER say NEVER!!!!!!!!! There is ALWAYS a way!!!! You just have to find it, so DON'T give up and proceed looking until you do.

Several options have been listed, and you could even try the thing they do online and ask the general public (bless their hearts, they often give to those who need a procedure, and can't afford it otherwise, for whatever reason). There is ALWAYS a way!!!!!

Now, remember, this may take some time, so DON'T give up while you're waiting, proceed with your plan, continue doing what you have been doing, and SHOW the insurance companies AND your doctors you are serious about this...it may be the key to getting your surgery. Dedication to the program shows ALOT!!!! The most important thing is to NOT give up on YOU! You are too important to let self-pity take over, and you are too strong to cave! Hang tight, my friend, and all will work out. Have FAITH!!!!!!

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And a P.S. ......... All this time you have been working so hard, that time may just be enough to get you past the wait-time some insurance companies demand, IF you can show it is documented by your previous doctors. Make sure you get IN WRITING all documentation, they should have kept records showing your progress and in what time-frame. Best of luck to you!!! Keep us informed!

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My insurance (through work) doesn't cover it, so I signed up for my husband's for a year. (Added cost of premiums about $3000). They became my secondary insurance, and they paid for my surgery. I will drop that insurance, and will pay for my one-year follow up myself. Still saved 1000s of dollars though.

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Whatever happens please don't let this setback lead to other ones...i.e., letting go of the great progress you have made without surgery. I would say keep on this course, and either get an insurance that covers it or go to Mexico, and when you finally get it, the prospects of meeting your goals with it will be that much greater.

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Jerr-bear,

I am so sorry! What a disappointing finding, and you are right: infuriating. The others have given some good advice about looking into other options (self-pay/Mexico) and also about documenting your current weight loss.

Whatever happens, don’t use this as an excuse to give up on yourself. Keep up those amazing weight loss efforts – 60 lbs. is proof that you’re able to be disciplined and you’re really dedicated. Try not to look back and regret what might have been. Just look at what is and what WILL be if you keep working hard.

Good luck. I am sorry you had such bad luck.

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Sorry for the news as @@SaraSleeves said try and consult with the Nicholson Clinic.

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • 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. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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
      1. This update has no replies.
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