Well, Crap!

Had my first surgeon's visit today.  That actually went really well...I loved my doc, and I loved his office staff even more.  I was truly impressed with them.

HOWEVER...

the insurance coordinator called to ask about for WLS under my current plan, and, as it turns out, my plan only covers Lap Band and RNY.  They will approve VSG only in extremely rare cir****tances, and only for a very specific list of comorbidities, none of which I have.  I tried to argue my way out of this, and, after 4 phone calls, and a total of 3 EFFING HOURS on the phone, I didn't much care for the answers I got.  My surgeon and I have agreed that it's probably best to just go ahead with the change in plans.

I guess the important part is that I still get to have surgery, but I really preferred VSG to any of the other options, and I was really getting to like this board!  So it's with a heavy heart that I bid you farewell...I guess I'm off to the RNY boards.  I may visit here once in a while, just to say hi, if that's ok.

While I know you are already preparing for your journey, what about holding off for a while? Perhaps your insurance will cover VSG by January. So many insurance providers are adding VSG to their list of covered WLS. And if medicare approves it, most insurance providers will feel compelled to cover VSG as well.
I probably would have forgone WLS if lap band and RNY were my only choices. Neither surgery really appealed to me.
Whatever you decide (and it does sound like you've decided to go with RNY), I wish you the best of luck!

I hate to hear that!

If you're really that bothered by having to go with a RNY, have you looked into self pay options? There are ways to finance surgery... I actually put mine on a credit card.

Not trying to change your mind. Just giving you food for thought.

Either way, don't be a stranger. We like you! Sure, some of the stuff on this board is really vsg-specific, but not all of it. Feel free to stick around and use what you can, and leave the rest

Awww, thanks!  I like you guys, too!

Self-pay is SO not an option, being as we have a really large family to support, and just recently bought a house.

However, kairk's suggestion actually makes sense.  I can't have surgery until after January anyway, due to PTO constraints at work...by the time I finish my 6-month diet, I'll be right on the fine, hairy edge of a PTO blackout that lasts through New Year.   (Our company serves the retail population, so we have to work with their busy season, and I'd rather have time to recover fully before returning to work than feel like I'm in a rush to get back.)  Right now, the surgeon's office has the same requirements, regardless of the surgical method, so I can still get my requirements out of the way, and possibly change my surgery type if coverage is added to my plan after the first of the year.

It's worth a look into, anyway!

Your surgeon will probably let you change your mind about which surgery you want anyways, especially if it's due to a change in insurance allowances.  Definitely look into that, because this is a lot to go through for something that's not exactly the way you want it, IMO.

Good luck!  If anything, I'll still see you on mfp, right? ;)

You will definitely still see me on mfp!

 I agree - I dont think you should have a procedure just because its your only option. Dont forget that while yes, you will start the weight loss sooner if you do the RNY, you will ultimately have to live with it for the rest of your life. 

If it were me, I'd wait until the VSG became an option. I would have elected to have no surgery rather than one i didn't want. 

i know how you feel.  i wanted the RNY - had researched it, was planning for it, was so excited about it... you know the deal.  then i found out the VA center that could do the surgery only offered the sleeve.  i contemplated waiting to see if i could get the procedure i wanted from another location that would be open to accepting patients from my area eventually - but there was no definitive timeline.  improving my health and getting rid of my co-mobitities was my top priority so i switched gears.  of course, now, i'm tickled to life that i was able to get the sleeve.  don't know that if i had the option for the RNY i would have still chosen the sleeve - but we can't deal with what if's, right. 

i'll be praying for you - i know these kind of hiccups can be rough. but it sounds like you are working with a great team of people and i'm sure together you'll get to the right place.  just remind yourself - there's always more than one way to get to your destination. just get there! take care. :-)

More and more companies are adding VSG to their approved list as the surgery is becoming more common. Mine just added it this past January. It might be worth calling your insurance company back to see if they are considering adding it at any point in the near future and if so, what the timeline is. If it is a difference of waiting just a few months, it might be worth it. But if it is still years out, RNY might be an option. Regardless, I wish you the best.

 Has the doctor submitted your paperwork yet? Even though you KNOW it will be denied, have them submit it for the VSG anyway. Then research all your options for appeals, more then one person I know has gotten them to approve the surgery they wanted based on an appeal. Don't just settle b/c you feel like you have to, there are options.