Help! Second guessing myself

Hey everyone. I am scheduled to have RNY next week, 8-5-13. I have been going back and forth in my head and actually think I want VSG. Insurance approved RNY (I have Cigna). Will they approve a change this late? I meet with the surgeon Wednesday July 31st for my pre-op appt and will bring it up then to see what he thinks. When I met with him initially he recommended either RNY or VSG. He left it up to me but I originally thought RNY would be better since its the "standard." Please help.

Jessica

I have no advice for you since I was self-pay... but I wanted to say good luck! This is such a hard choice to make and insurance never makes it any easier for us! I look forward to hearing what the others have to say. 

I also was self pay so I have no ideas on what your insurance might do.  I would have to think if it were an issue of money for the insurance company then the VSG is actually a cheaper surgery than the RNY so they would be out for a lesser amount.  I can't imagine an insurance company complaining about that.

As for the last sentence I would have to disagree slightly.  My surgeon and others right now perform more VSG surgeries than the RNY surgeries.  While true that the RNY has been around longer and that it has been the standard for a long time I truly believe that this is changing.  If you can have a less invasive surgery such as the VSG with the potential for lesser issues (surgery time is quicker so you are knocked out for a lesser amount of time, you don't deal with the malabsorption issues of the RNY, you don't have dumping syndrome as in the RNY, and other benefits to the VSG) that works as well and actually better in a lot of ways than the RNY ... then I think it will be the new standard if it isn't already.

All that being said you do have to realize that I am biased a bit as I had the VSG and was extremely successful.  I lost 95 pounds within less than 6 months post op with what I consider to be very little issue.

It really is difficult to guess on whether or not your insurance will approve the change.  I can't imagine that they wouldn't but I also don't want to get your hopes up.  In this world if things always made sense life would be so much easier.  Insurance companies have been known to fall under the realm of not making any sense in their decisions.  

 

YOU control the timeframe. My $.02: call the surgeons office and put a hold on the surgery for now and get back in to discuss with him. Pull your insurance info and find out if vsg is covered or not. Get the insurance coordinator to resubmit it for vsg, if you decide to go that route. I switched from RNY to VSG about a month before surgery, after a hellish battle with United, but it all comes down to whether they pay for that procedure. Good luck!

I know that my plan pays for either surgery.  Thanks for your help.

My surgeon's office accidentally submitted me for RNY at first and it was approved.  They had to resubmit for VSG and it got approved within just a couple days.  If you qualify for one, you'll qualify for the other too. 

That's what I'm hoping!

I'm still preop like you are but I also have Cigna.  I don't know if you will be able to keep your surgery date but it's worth a try if you have this much doubt.  I called Cigna at the very beginning of my journey and they were great to answer my questions.  Why don't you call them today and inquire about it?  Then you can call the insurance coordinator at your surgeon's office and tell them your concerns and ask if they would be able to make the changes while keeping your surgery date.  Good luck and keep us posted!

Thanks.  I am going to call today and see what they say.  Wish me luck!!! :)

To me, it is seems that you should call the insurance company pronto.  What if changing surgeries is not an issue? If it is not an issue- get an email, fax, code, or something to prove the change is acceptable- then tell the surgeon and staff a.s.a.p.  First thing is first- insurance company.

If it is approved but is  delayed, then I would say it is a worthwhile delay (and probably not long).  You will have more peace going into the surgery of your current choice.

And I agree with a previous poster. "Standard" is more about frequency than quality. My surgeon does more RNY but is increasingly doing VSG and said in his seminar that he thought it would become the "standard" over time.

 

Good luck.