Just begining to seriously consider WLS

I am new here and am just begining to seriously consider WLS.  I am curious about how the process starts.  I have not been to a Dr. on a regular basis for a few years.  I have not had any major issues that required me to do so and have had some less than ideal insurance which I had trouble finding a doctor that would accept it.  I will be switching insurance providers in the upcoming months, and hope to get on the road to a thinner me. 

So, my question is, does one typically need to go to a PCP and get "confirmation" morbid obesity to move on to a bariatric surgeon, or can you just do your own research, find a bariac surgeon and begin the process?

Thanks for any direction you can provide.

-_Gretchen_-

I asked my PCP for a recommendation, but many people just find a bariatric surgeon and begin the process.  It is pretty easy to calculate your BMI.  Generally if you are above 40, you qualify.  If you are 35 or above with diabetes or other conditions you will probably qualify.  Check out requirements with the new insurance company.  Each company has its own guidelines and requirements.

I started with attending information sessions for two different programs.  I think that is the best way to go if you don't have a regular doctor that you feel comfortable with making a referral (I do happen to have a GREAT PCP but I knew she'd approve since we'd discussed the option in the past).  At the information session, they will give you all the info you need to get on your way.  My chosen program and insurance policy required a form to be completed by my PCP stating that she felt WLS was right for me.  The other program did not require that step.  Every program and insurance plan is different.  Look around for the programs in your area and attend a couple of information sessions to see which works best for you.

Good Luck!!

I started out by going to an information session run by a surgeon I'd researched and liked, and I already knew he was in-network for my insurance company. I got to chat with the surgeon there, and at my first appointment with him he gave me a list of all the things I'd need to round up: records, referral, and diet check-in with my PCP, sleep test, blood work, etc.

It was a great way to get some info and figure out what I still needed to research, and there was zero pressure to make an appointment or pay any money. I had lots of time to think it over and make a decision and talk to my other doctors about it.

You make an important point here - you were not pressured to make any further appointments or pay any money.  I found it odd that some programs charge a large "program fee" and pressured people to schedule appointments asap.  I couldn't find a valid reason for the "program fee" since I and my insurance company were paying for just about everything that needed to be done.  

Yeah, that's one of the things I was worried about at first-- I thought the doc was going to come in wearing a tie and give some sort of timeshare-esque sales pitch. But nope, he came in with scrubs and sneakers, gave out packets of information, and encouraged people to ask questions. If it had been a high-pressure environment, I probably would have walked away.

I didn't have a PCP at the time I started my research either.  I went to the orientations offered by the bariatric program at one of the local medical centers and then had the surgical consult. The coordinator gave me a list of PCPs at the center that have worked with their bariatric patients in the past.  I've had a couple of visits with her, but she wasn't the primary driver in the run-up to my surgery.  I know every program is different, but I'd advise starting with your insurance to see what their requirements are and then checking out the bariatric centers in your area that meet their criteria.  :D

Good luck!

Jen

It really depends on the insurance.  I was able to select the procedure and surgeon myself (within network), but part of the approval process included a letter from my PCP supporting my decision to get WLS.  Once you decide on an insurer, go to them first to find out what all you need to get approved and start jumping through those hoops.

Thank you all so much for your advice. I will see if I can get a plan booklet at work and maybe start digging in to even if it's covered thru the plan before my enrollment even takes place. If not my husband and I have already decided we will self pay if necessary. 

-_Gretchen_-

Well i got the plan books today for the insurance I will be switching to in a few months and was disappointed to read under Medical Limitations and Exclusions  "Any services or supplies provided for reduction of obesity or weight, including surgical procedures, even if the Participant has other health conditions which might be helped by a reduction of obesity or weight, except for healthy diet counseling and obesity screening/counseling." 

I guess on the bright side I will have the freedom to choose  who and where I will have my WLS.