Newbie Needs Assistance

I thought this would be the best place for my little introduction-question/s. So hello! I'm 25 and the proud mother of a *****y little 18mo girl.

I've done a lot of research and think a VSG would be the best for my situation. So whats the first step? Call the insurance people first? See my primary doc? Or go strait to the surgeon first? I have excellent health insurance(bcbs federal) but time is running out. I'm on my parent's plan and they "kick you out" when you turn 26. I don't know if they let you go the first of the year or wait till your bday month though. Either way, the sooner the surgery, the better. I'm sick of going to the ER every few months for asthma problems.

Here's a little background info if anyone has any advice for me: I weigh 211 as of this morning. Lightweight? Maybe. Too light for surgery? My BMI is36.2ish. So just above the BMI 35 cutoff. Scared I won't even qualify. Hight is 5.4. I wouldn't even consider surgery if I thought I could lose the weight myself. But I don't. I have major portion issues and have trouble walking up the stairs, much less exercising, due to asthma. I'm pre-diabetic. It runs in my family, I had it when I was pregnant, yadda yadda yadda. My blood pressure was high my last few doctor visits. And though I haven't been tested, I'm pretty sure I have sleep apnea. Oh and don't forget the chronic back pain that I've had since forever. At first I thought all I needed was a breast reduction, but now I feel my health is getting out of hand. If I don't do something about it now, I fear I won't live to see my grandkids. I want to have more kids of my own someday. Be able to run around the yard with them. Or ride amusement park rides with them. Last time I went to the fair, I could barely fit on half the rides! Big wake up call for me. Ok this post is already too long (sorry!) so I'll shut up now haha. Thank you for reading and helping!

I was 198.5 when i started the process....I qualified due to a few co-morbidities sleep apnea, heital hernia, lots of back, hip, and knee pain, gurd...super bad!  I am almost 5 weeks post op.  I am starting to feel back to my old self.  I have lost 23.2 since surgery and 27.3 total.  It has been the most amazing thing I have ever done for myself.

I would check to see if your ins covers Bariatric surgery.  And what they need, do you need to be referred to a surgeon, Or can you just go to see one.  

Good luck....its amazing sitting here on the losers bench!

 

Gayle

Check with your insurance company next. I've seen too many people get their heart broken by making plans and decisions only to find out that their insurance won't cover surgery. That being said, your insurance company saying "no" IS NOT THE END OF THE ROAD! There are many, many people on OH who have fought against their insurers and won.

 

Agreed, first check with your insurance company - if WLS is covered under your insurance plan I would next go to your primary care doctor for a referral to a surgeon (you may get in faster with the surgeon if you have a Dr. referral). From there the surgeons office should have a group of people that will be able to get the insurance approval process rolling - it is their job to fight for you, with out you and your surgery they would not have a job so they are your advocates...use them! Make sure the doctors all understand that your insurance coverage is soon coming to an end so the process needs to be as quick as possible... this may or may not help you but it is worth a try! Your BMI is on the "low" side for approval - but with the medical history and co-morbidities that you have you should have a good chance of getting approved. Good luc****ep us posted.  :)

Call your insurance company first to see what they require for you to get approved, and because it's a newer procedure, make sure that the VSG is covered.  You may have several hoops, including a supervised diet, so find all of that out so you can start coordinating your efforts from there.