Blue Shield of Ca insurance and approvals

gmjsgirl
on 12/9/15 9:30 am

Good morning all, 

I am new and am seeking to have the VSG. I have Blue Shield of California and was wondering how long it took from consultation to get approved? I am going to my Seminar and Consultation on the 16th. Back in 2009 i had BCBS of Illinois and was denied three times due to improper documentation of diet.  I finally gave up and now need this to be healthy. I have been on many diets since then where i lost weight but then put it right back on. I didnt necessarily always use a medical weight loss program. I have been on Weigh****chers, Medifast, Carb Essentials, Diet Free for life among many others. I lost but then the weight came back on and some. I am currently 301.4 pounds an 5'5" tall. Looks like a BMI of 50. I want to be healthy so i can see my grandchildren grow. I need help in what i should now that things have changed when it comes to insurances and weight loss surgery. Has anyone of you went thru Blue Shield of Ca in 2015 and how hard was it to get approval? I am going through Dr Ludwig at North Valley Surgical Associates in Chico Ca are there any of you that when thru there with Blue Shield of CA? I would love all the information i can get about everything regarding surgery, insurance approval, pre-op and post-op. Thank you and im looking forward to getting to know y'all on here. Be blessed.

larra
on 12/17/15 11:22 am - bay area, CA

Hi gmjsgirl!

Well, no one seems to have the answer to your question, and that includes me, so I'll ask you a different question - have you researched all your bariatric surgery options, including the DS? The DS works well for anyone who meets the standard medical criteria for bariatric surgery, but is esp useful for people with a higher bmi because it has the best statistics for percentage excess weight loss, for maintaining that weight loss, and for resolution of almost all comorbidities. With a bmi of about 50, IMHO it is something you need to know about and consider.

the DS also avoids many of the drawbacks of gastric bypass - dumping occurs rarely if at all, you can take NSAIDs safely (in correct doses) whereas with gastric bypass they are contraindicated for the rest of your life, you can drink liquids with meals, and there are no foods that are forbidden for life. You would also have these advantages with VSG, but the weight loss and esp the maintenance of weight loss are not as good with VSG, and in fact we are seeing people who want/need revisions from VSG to DS all the time.

The surgeon you have named does not do the DS, so either it won't be discussed at your seminar or it will be dismissed as "too dangerous" or "extreme" or whatever. In fact it has been a standard of care bariatric surgery for at least 20 years and if you know your protein and vitamin requirements and stick with them, long term results are excellent.

Feel free to pm me for more info, and I wish you the best with whatever you decide.

Larra

   

gmjsgirl
on 12/17/15 4:48 pm

I am actually wanting the VSG and i have researched all the options. I have been researching since 2009 when i was denied twice. I have friends that have had it and are doing amazing. I have had my consult with the Doctor and i was suppose to meet with the coordinator but after them having me wait til 6pm the then told me that they would call me which the still havent. But anyway thank you for comment. Happy Holidays.

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