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Weight Loss Surgery If you've had it, or are considering it, share your discussions here

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Old 07-12-2012, 06:39 PM   #1
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Talking Thank You!

I want to thank everyone who has been so very helpful the past week or so. I have been given some great advice and insight about WLS.

Tonight I meet with my "Case Worker". Because of some of the suggestions that I received here, I contacted my insurance company,not just once, but twice. The first time about all I got out of the conversation was, yes baratric surgery was covered, BUT it had to be done at a Blue Distinction Center.

So after reading a few more posts that said call them and call them more than once, I did just that. Today I talked with a wonderful woman who told me where I could get the "rules & regulations" reguarding coverage, prerequisits, everything needed. She even told me that there are some things (like the doc supervised weight loss that aren't covered as well, but once the approval for WLS is done they will go back and cover them, for two years prior.

I have learned of the different types of WLS. I am leaning toward a DS and will discuss it with the surgeon. I will listen to any suggestions he has, but in the end I will choose the surgery I want. And yes I found out a DS is covered by my insurance as well.

I also found out that because my BMI is over 50, I may also qualify to have excess skin removed. That was soething that was a bit of a dark cloud over my head.

I would name each of you who have been so very helpful, but I am afraid I will accidentally leave some one out. Every one has been so helpful and supportive!! It is just amazing!

I look forward to this journey and am thankful for the amazing support!!
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Old 07-12-2012, 07:41 PM   #2
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that's what we're here for, Kate, and i'm so glad that you're making progress! keep us posted.

now, all we have to do is convince Tera to come back!
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Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

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Old 07-13-2012, 12:38 AM   #3
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Oh did they chase Tera off! What a shame!! I am so glad I did not get the response she did when I first posted about WLS.

I found out tonight that the case worker has worked with my particular insurance before. She said my insurance will still cover it, but at lower rate. We are fortunate and have a lower deductible, so end the end the difference between having it done locally and at a "Blue Distinction Center" would be about $500. Since the closest BDC is approx 100 miles away, when all associated costs are included it would be cheaper to have it done locally. Meaning...we still may be able to sneak it in before year end.

Maybe my motto should be "New Year, New Pouch!"
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Old 07-13-2012, 09:31 AM   #4
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great attitude!
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Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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Old 07-14-2012, 12:22 PM   #5
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Yay Kate! Sounds like you're well on your way. Congratulations!
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WLS 5.17.2012 - MGB, Dr. David Hargroder - HW 247, SW 232, CW 113, GW 125-130
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Old 07-15-2012, 11:06 AM   #6
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Quote:
Originally Posted by KateB View Post
I also found out that because my BMI is over 50, I may also qualify to have excess skin removed.
THAT is amazing! I have never heard of an insurance company making that coverage determination based on your starting BMI - that is interesting. My excess skin removal wouldn't be covered because I'm not having any major health issues from it (like rashes or fungal infections). They don't care that my clothing choices are very limited despite being a "normal" size, that I have to wear shaping restrictive undergarments even when it's 100 degrees out, or that I have more than once caught my lower stomach skin in my pants zipper As much as I would love to have my excess skin removed, I don't think I could ever spend that much money on myself out-of-pocket now that I have a baby (and we are considering #2).
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Benjamin David born March 24, 2012, 7 pounds 11 ounces
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Old 07-16-2012, 10:14 AM   #7
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carly - i can tell - when you're all done with this, you're gonna be drop-dead GORGEOUS!!!!!
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Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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