Weight Loss Surgery - Starting my journey




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brandnewme
08-30-2009, 07:47 PM
Hi everyone! I have officially made the decision to have WLS. I am still not quite sure which way I am going to go, but I have some time to decide. I am still waiting to hear back from insurance to see whether or not they cover any bariatric surgery. In the mean time I have started working with my doctor so I'll have the supervised portion covered. And, even if they don't cover it, my goal is to get my finances straightened out so I will be in a position to self-pay sometime in the near future. I will have to take out a loan to do it, but a loan vs my life? No question there!

I will be hanging around and probably asking a few questions here and there!


Leenie
08-30-2009, 09:02 PM
Congratulations :hug:

Ask away ;)


.

jillybean720
08-30-2009, 09:26 PM
Hello fellow 300+ club member (I believe I remember you from that forum here on 3FC)! Fingers crossed you get a good answer from your insurance company...who do you have? Some companies post their requirements on their websites. I have Aetna, and their requirements were pretty easy to find online. I was also able to find the requirements when I had BCBS of NJ. The real question is whether your company has included the WLS rider in your policy.


ladybugnessa
08-31-2009, 09:07 AM
welcome! best of luck to you.

jiffypop
08-31-2009, 01:47 PM
YAY!!!!! big step, Brandnewme - and we're glad you've stepped into the pond. what was the turning point? what was the LAST STRAW that got you decide that this was worth looking into for you?

sometimes decisions are the BEST - no matter which way they go, you're at least pointed in a direction.

brandnewme
09-01-2009, 11:06 PM
Good evening ladies! Thanks everyone for the welcome!

Jilly, I have Cigna and most policies do not allow for bariatric surgery, but some companies include it. I haven't heard back yet, but I am hoping to hear back sometime this week.

Jiff, I was in a car accident 5 years ago and shattered my right ankle and still have a lot of issues with it. Then I fell in late January and broke my tibia and fibula on my left leg, and also tore a ligament. I had surgery in early Feb, and as far as healing time goes, it went much better this time. The problem is, now neither leg is very stable and I am afraid if I fall again, it will be a lot worse. Plus I've already developed arthritis in my ankles, knees, and hips, and it's only going to get worse. I guess the final straw would be the fact that I have lost, gained, and relost anywhere from 50lbs to 75lbs so many times that I'm just done. Lately I haven't been able to lose even a pound and maintain it, and I am doing a lot better than I have in a long time! Plus, the fact that I'm only 27 and I have yet to really "live", and I will be darned if I don't get a chance to live a little before everything gives out!

mel3rn
09-09-2009, 01:43 PM
Did your doc talk about cost at all? I am in the same boat. Except my insurance will cover it but my BMI has not been high enough for 2 years! I am thinking if paying for it myself. Just havent been able to pin down an amount.

Melanie

brandnewme
09-09-2009, 09:45 PM
Mel, I was quoted at roughly $20,000 for Lapband and $25-30,000 for RNY (not counting follow-up or all the pre-op stuff). These were both for laparoscopic surgery. The cost goes up if you have to have an open surgery, and obviously if there are any special considerations. If you have any complications the price also goes up. A lot of it will depend on where you have surgery and who your surgeon is.

jillybean720
09-10-2009, 09:37 AM
Mel, I was quoted at roughly $20,000 for Lapband and $25-30,000 for RNY (not counting follow-up or all the pre-op stuff). These were both for laparoscopic surgery. The cost goes up if you have to have an open surgery, and obviously if there are any special considerations. If you have any complications the price also goes up. A lot of it will depend on where you have surgery and who your surgeon is.
That's strange - I can only speak for the world of the DS since I nixed the idea of RNY long before cost for surgery even crossed my mind, but an open DS is typically cheaper than a laparoscopic DS since special tools and equipment are required to perform a procedure laparoscopically. I know in the US, you can get an open DS for less than $20k.

brandnewme
09-10-2009, 11:29 AM
I think part of the reason it costs more is that they'd have to move you to the actual hospital instead of the surgical center here. It is probably different elsewhere, but we have basically a surgical center that does all the lap surgeries, and the hospital has to do anything that is open.

brandnewme
10-02-2009, 08:58 PM
Well, I finally got a definitive answer from my insurance. They do not cover it in general, but the surgeon may request special authorization if you are considered in dire need of having it done. They have rejected almost every request for authorization, but there have been a couple people who met their definition of dire need. So basically I am still playing a wait and see game, but I at least know there's a very small window of opportunity.

I am still struggling to stop gaining - I know a lot of it is still water weight, and I am sure since my thyroid is unregulated right now that doesn't help, but in general I just need to stop messing around and do what I know I need to do. So.. not a whole lot further, but not counted out either. I did get an awesome raise & bonus this year, so I have been putting money aside just in case. Either way, I'm on my way.