Question:
Where do I begin?
I am interested in either getting a tummy tuck with Lipo, or a Gastric Bypass. I am hoping my insurance with cover it however I don't know where I should begin. Do I find a doctor first to see if I am eligible or what? Please help me Thank You — Tiffany S. (posted on August 4, 2005)
August 4, 2005
Tiffany, those are two VERY different procedures. I think you first need
to decide which procedure you are looking into and then go from there.
Typically with either surgery, if you want insurance to pay, you need to
visit the surgeon and they will submit for approval. With a BMI of 35 you
will be in for a fight with the insurance company unless you have some
weight related medical conditions.
— RebeccaP
August 4, 2005
Tiffany, I have to agree with Rebecca...Having surgery is a life changing
thing. Just remember that If you choose to have what's called the
"RNY" procedure that is non-reverisible. It's a major surgery
and if your looking just to shed a few pounds or get rid of some skin, you
might want to do the lipo thing or just talk to your primary doctor.
Listen to your doctor he/she will give you insightful information. If you
choose to have Gastric, really take time to re-search it, it's not a
"Quick Fix". For most patients you have to at least be a 100lbs
or more to quilify or have a BMI of 35 with pre-exsiting conditions (ex.
high blood pressure, sleep apnea). Do research, can't stress that enough!
Good luck to you!
— Lori
August 4, 2005
Tiffany, TT & lipo are not surgical treatments for being overweight.
You really need to loose the excess weight before you consider any
contouring surgery and you have maintained your weight loss for 18 months.
You first need to look into if your insurance company will consider a
person with your BMI. Do you have co-morbids? Even with co-morbids your
insurance company is a tuffy to get approved, my husband was denied with
Cigna and his BMI was 55. Cigna with most plans requires the person to have
doctor supervised weight loss trys. Please first try to loose weight in the
conventional manner, you may be surprised and are able to do it. Then if
you cannot loose weight start getting help from a doctor to loose weight.
You may want to consider self pay lap band. Some doctors may consider
taking you with your BMI.
— ChristineB
August 4, 2005
Christine...I would have to disagree with half of what you said in your
message. I believe if a person has been over weight all of their life,
they shouldn't have to prove to anyone including themselves that they have
be on a 18mo diet and or a supervised diet from a doctor. Not everyone has
to go through that, if you believe that you have tried certain things and
that surgery is what you feel is right for you and you have discused this
with your primary doctor then more power to you.
— Lori
August 4, 2005
Lori, unfortunately whether we should have to prove we can lose weight or
not, this has become a major pre-requisite for many insurance companies.
Christine states that she has had experience with Cigna, the insurance
Tiffany has so she is probably correct about the diet thing.
Tiffany, I have to agree that the 2 surgeries are entirely 2 different
procedures! The Gastric Bypass is a MAJOR, life-altering surgery. The
tummy tuck is a cosmetic procedure. If you are seriously weighing the 2, I
would recommend going with the tummy tuck as you probably don't need to
lose an extreme amount of weight (which is the purpose of the gastric
bypass). You will also probably not qualify for the bypass due to the
psychiatric eval that most insurances require now. Good luck with whatever
you choose! Carmen
— kccjer
August 4, 2005
Ladies, Ladies! For starters, I know of a few who have had Cigna, and they
have been denied from having surgery, even WITH Co-morbs! Now, Tiffany, I
would really think here what you are asking. The advice you have gotten so
far is by far good advice. Personally, I have known people who have had
Lipo and have not done well with it.. and this prevented their chances of
having Lap because of how many times they had Lipo. Also... To be honest,
we are born with a certain amount of fat cells in the body.. these
remain... unless taken out by surgical procedure... and regardless if you
lose weight or not, you will still have the same amount of fat cells...
just they will be smaller in size. Right now, they are increased in their
size.
For now, Find out what your insurance needs as proof... and stick with it
for the 6 months.
— Disneyfreak
August 5, 2005
If you need to loose a hundred pounds or more a tummy tuck and liposuction
will not do the trick as well as alot more painful. Look at the different
types of WLS and weigh your options as to which one would be best for you.
also contact your insurance company right away and find out whether they
cover any type of WLS specificly. mine woudl not cover the LAP-Band, but
they would cover a RNY done lapriscopic. each is different.
— afs720
August 5, 2005
Wow, didn't think I was going to get attacked on here...lol I was just
trying to help. Umm I guess now I realize that I might just not answer any
more on this message board, people do have different views on all sorts of
subjects, I just don't think everyone should go after one person. I was
just merly saying that having "RNY" Vs. having a revirisble
surgery (ex lap band or VBG) is considered non revirisble. Doctors do say
that In an EXTREME EMERGANCY than can reverse the "RNY" I have
done my research for over 2 years, but they say that if you choose the
"RNY" to not think it's reversible, and to think of it as a
permante thing. Sorry Tiffany for all the confusion, I do appoligize for
the way some people choose to not read between the lines. One more thing I
might add... Some insurance companies do require that you be on a diet by a
doctor, I do agree that you should do what you have to in order to have the
surgery, the people that attack me on this message site, didn't read
between the lines...I'm saying that if your insurance company doesn't
require it, that you shouldn't have to feel like ohh one more diet...kind
of thing. If that's how you feel.
— Lori
August 5, 2005
Tiffany,
I can only speak from my own experience. I checked with my insurance
company first to see if they would cover a gastric bypass. Once I knew what
they would/wouldn't pay, I went to a seminar given by a group of bypass
surgeons to select the one I wanted. My decision to have the surgery had to
be based on cost as well as need. Best of luck in whatever you decide.
— Loy W.
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