Trying to learn about bypass surgery

I was on this site last year, but just couldn't afford the "hoops" that my insurance company wanted me to go through before they MIGHT pre-approve surgery, so I just gave up.

Today I had a regular check up with my doctor and I am heavier than I have EVER been, even when I was pregnant with my son just 5 years ago.  I was 250 lbs for a long time, but today I was 298!!!  I'm only 5'2".

I have horrible arthritis in my knees, feet, hips and lower back.  My doctors feels this has a lot to do with my weight.  I also suffer from chronic depression and I take a lot of medications.

How can you take your meds after this surgery?  I don't think any of mine come in liquid.  Right now I think I take 12 different meds.

I have new insurance starting July 1st and they don't cover ANY weight loss treatment at all.  I do have Medicare part A and B and was reading on thier website that they cover 80% of the surgery.  Are there a bunch of hoops to go through for this?

I have not clue how much this surgery costs, do you have to pay upfront?  I saw a bariatric surgeon last year and had to pay $250 for that visit and one class.  For us, that is A LOT of money.

My son was born with a chronic medical condition and we have to travel out of state for his care, so the credit cards we have are maxed out.  We have nothing worth anything to use as collateral for a loan and due to the amount we owe on credit cards (debt vs. income) we couldn't just get a personal loan.

Anyone have any advice?  I am not even sure where to start.  There is only one hospital in Montana that Medicare will pay for and it's 3 hours away.  My parents happen to live there, so having surgery there would probably be doable, if I can find a way to afford it.

Thanks,

Shelly

If you use the Search box in the upper right hand corner you can review all the old posts on any topic you want. Some meds have to be crushed, others cannot be. You can't take extended release forms. It all depends on the specific medication.
I'm confused as to your insurance. If you have Medicare A & B, how are you getting new insurance? If you are going to a Medicare Advantge program, then they may pay more than Medicare. You might have a deductible and co-pay.
But you said your new insurance doesn't cover it at all, so you can't be doing that.
I can't imagine you being able to get surgery done before July 1st at this late date. It would also have to be a Center of Excellence for Medicare or a Medicare Advantage policy to cover it. You would need 3 months of a supervised weight loss program that meets their specifications for documentation for starters.
My Medicare Advantage plan covered all but about $6 of my initial consultation with the surgeon since I had already met the deductible for the year.

Sorry, I do have private insurance through my husband's work.  That is what is changing on July 1st.  I have "regular" Medicare (due to disability).

Thanks for all the responses everyone!  I have a lot to look into!

Shelly

Don't really have an insurance advice but I wanted to say----DON'T give up!!!

WLS will solve MANY of your health problems and get you off some of those meds.!  Sounds like you need to find a GREAT primary care doctor OR bariatric surgeon that will be an advocate for you.....

Both of my doctors said that wouldn't quit until I got the surgery!  They both really went to bat to get me approved!  If money DID happen to become available, surgery in Mexico could be an option....I've seen my success stories here on OH and it seems very affordable!

Hang in there!!!  Best of luck!

Each insurance company, and your employer's opted plan dictate the requirements for surgery.  Be advised, you'll have lifelong additional expenses post op too. Daily vitamin supplments, calcium citrate, probable iron, suggested dry d3, high protein foods, minimal junk foods, etc. These are all expenses that are post op. True you'll eat less, but you'll have to have higher quality foods than pre op.  You'll either have to do the steps your insurance company demands, or pay for surgery yourself.  It appears your Medicare option may be best. I wouldn't complain about being 3 hours away. My surgery hospital was an hour away, and I still drive to that location for support meetings every month.  Good luck. DAVE

I cannot tell you about Medicare, but MOST surgeons offices do require that you pay your known portion of the surgery up front.

As far as taking meds after sugery, I took all of my normal meds (pills) two days after surgery with no problems. Many people do the same since many surgeons do NOT require liquid or crushed meds/vitamins (unless they are extremely large (such as calcium pills... and even those I was taking the "petite" ones 2 months after surgery with no problems)).

Lora

Can't help you with the insurance as I am Canadian... but re; meds. The only med I took before surgery that i still take after surgery is Synthroid. It's tiny and I can now swallow it whole (just did a min ago) but it's also safe to crush. Most folks, crush or split an take with applesauce.

Before you go in for surgery, you should be talking to your doctor that prescribed the med to get direction from her on what you will need to do before / immediately after / long term after about medication. Mine took me off most, and I've not needed them since.

When I started this process over a yr ago our insurance would cover this surgery, but husband changed employers and the new ins. did not cover it.  I almost gave up, but we got a great tax return this yr. and wonderful husband told me to deposit the check and schedule it!

Pre-op apt on 6/8/11 and had to pay in full then.  Our tax return covered most of it and we took out a small loan to make up the difference.

How much did you have to pay?  I'm trying to get an estimate about how much it costs around the US.

Hope it goes well for you!!!

Shelly

looks like medicaid would pay 80% percent. then u r responsible for the rest . y dont u call these insurnace compnys and ask them some questions. i had to go to the dr for 6 months of weight loss mangment . then had boo koos of tests done . started in feb 2010 and just now waiting on insurnace approval. it takes awhile. so id get started on it sometime soon, if u r realy serious about getting this surgery at all. its very time consuming , at least it was for me .