Why does it take so long??????? *Impatiently awaiting news of approval*

Caligirl05
on 10/7/15 11:24 am

Hello,

I decided in May that I was ready for this...MAY! It's October! I thought the process would be fairly simple as my insurance didn't require a pre-surgery diet. Being that I'm a teacher, I was planning on a summer operation. BUT, July 1 my insurance changed. They still covered surgery but not at any of the hospitals in which my doctor has privileges. I called often to see what was happening with the case but...nothing! Finally my case worker suggested I called my insurance to apply for an appeal since I started the process before this change. I was told it could take another 30 days before they decide and at that point the answer may or may not be yes. I am soooooo frustrated! I originally wanted to go to Mexico (because I thought my bmi was too low). I did find a US doctor here that was willing to work with me but this process is ridiculous. Even if the answer is a yes, I will be facing a surgery during the holidays. I don't mind missing the food, but I don't want surgery to get in the way of our holiday vacations and plans...I already missed out on a summer vacation because I didn't want to schedule anything that conflicted with surgery. I am feeling so fed up and on edge. I'm renewing my passport now and researching doctors in Mexico in case this falls through but my husband is quite against this idea. It's so frustrating to think that I could've been possibly halfway to goal by now but here I am...waiting, waiting, waiting I guess I just needed to vent and hopefully get some encouragement

Simone13
on 10/7/15 3:54 pm

My insurance didn't cover it so I decided to go to Mexico to have my VSG! I was sleeved on 7/18/15. I went to Juarez Mexico. I did tons of research on the doctor and the hospital. I happy to report. I've lost 45 pounds and had zero complications!!! I'm very pleased with my experience from start to finish! I would do it all over again!!! No worries or reason to be afraid. It was totally safe and the cost was very reasonable!! Hope that helps and I hope everything works out with your insurance!!!

psychoticparrot
on 10/7/15 9:51 pm

The hoops the insurance companies make you jump though can make you feel like a trained circus poodle. And you never know until just before the surgery whether they'll approve you or not. Why all the hoops? In my darker moments, I think they're hoping you give up on the whole convoluted process so they won't have to pay. I can understand the need for the psychological assessment, and some nutritional counseling, but the six-month obstacle course doesn't make much sense to me. I never heard from my insurance company at all. My surgeon scheduled my surgery, and it turned out the insurance paid for it all. The whole insurance-medical negotiations are beyond my ability to comprehend.

psychoticparrot

  "Live for what today has to offer, not for what yesterday has taken away."

ChubbyHubby82
on 10/9/15 6:47 am
VSG on 07/06/15

I am one of those professional poodles.

Funny thing about poodles are that they are tenacious dogs and don't give up. Fight, Fight, and FIGHT some more. This is your health and I once took it for granted. I now fight for EVERYTHING and my health is my NUMBER 1 PRIORITY.

 

    

Sandra F.
on 10/8/15 6:05 am

I had my surgery with Dr. Fernando Garcia. For those that cannot get insurance to pay, it is a viable alternative. I am a year out, have minimal scarring and 106 lbs lighter, so I would call the surgery a huge success. I haven't had any complications either, other than the normal ones like nausea (when I first had surgery) and constipation (which I think everyone has at some point). Good luck to you no matter which way you decide to go.

    

      

(deactivated member)
on 10/8/15 6:11 am

I had my surgery in Mexico in July. I chose Dr Jesus Martin Lopez. I was very happy with the care I received. I was in his clinic for two days and a recovery house for two more. You can get surgeries done for under $4,000 and many other for under $5.000. If you just can't wait any longer and have the money I'd say go for it so you can get on with your life.

Caligirl05
on 10/8/15 9:18 am

Thank you all for your replies. Yes, I do know that surgery in Mexico is a viable option. I would be fine with it. It's just that I promised my husband that I would at least try for surgery in the states. My US surgeon had me sign a paper that if I chose not to go through with surgery, I would have to pay $3,500. I am afraid that if I give up on this insurance waiting game that I will not only have to pay for my surgery in Mexico, but then I will also owe the surgeon here this money. It's like being held hostage. I just need to make a move here but all I can do is wait, wait, wait. It's so nerve wracking. With all your help and my research though, I am at least being proactive. If this is denied in the next 30 days, I will have chosen and spoken with a surgeon in Mexico and will have my passport renewed so I am ready to go. If they do approve it here, well then I'll be ready for that too. I wish I could just set my date already. I know I'm whining. Sorry.

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