Seminar First / Medicaid Woe

[purrball 0]

Hi, this is my first post.

I have a long history of being overweight but I have gained a lot in the past year or so because I have a lot of issues with my spine (stenosis, degenerating discs) and arthritis in my hip so I can't walk very well or stand. My orthopedic surgeon at Lenox Hill here in NYC has suggested bariatric surgery and has referred me to Dr Mitchell Roslin at the Lenox Hill Bariatric practice.

I called them up and I need to attend their seminar first before I schedule a consultation with Dr Roslin.

I have Empire Blue Cross Blue Shield Healthplus (Medicaid) and I just know they are going to make me diet for 6 months before surgery. The thing is, I can't take 6 months more of pain! I am in pain all the time due to my back and it makes my life hell. Does anyone know if they make some kind of exception due to medical conditions like these?

Glad I found this community. I have been reading a lot of posts and have learned a lot. Thanks for listening.

[bleonhardt 46]

I haven't heard of an exception as most insurance companies, even private such as mine, require you to be on a medically supervised weight loss plan for months prior to the surgery. Sometimes if you have already given it a shot to lose on your own and that is well documented in your medical records over the last 5 or so years I have heard insurance companies approving pretty quickly. I wish you all the best on your journey!

[purrball 0]

I can be supervised by a nutritionist, that's fine, but I can't exercise due to my back because it's disabling. If I lose any weight during the supervised diet will I be denied the surgery?

[bleonhardt 46]

I have had four back surgeries so I can feel your pain! You will lose weight and the doctor will expect you to lose some weight on your own prior to surgery. That actually assists you in getting approved as it shows you are ready to take the plunge and do the lifestyle changes you will need to in order to be successful. Surgery alone does not make you lose weight and keep it off...you have to be able to make the required changes as well in order to be successful so the pre op part of the journey is how you prove yourself to your doctor and insurance co!

[purrball 0]

Ok thanks so much for your replies. I am really looking forward to the seminar! And I hear Dr Roslin is really great so it looks like I'll be in good hands.

[bleonhardt 46]

You are very welcome! Keep us posted on your progress! =)