Feeling defeated....

NatalieKelley
on 6/10/14 4:35 am

I went to my consult with the surgeon. My BMI is 38.3. As far as we know I do not have any co-morbidity. He wants me to get my glucose checked again and have a sleep study done because I snore. I called the place that does the sleep study and they want to do a consult before the study etc. I just see the dollar signs adding up and I am starting to think I wont get insurance coverage. WHAT DO I DO????? I'm miserable. I went home and just cried because I felt so ashamed and disappointed. I'm 10lbs away from having a 40 BMI but I dont want to GAIN weight. I feel like that is cheating. PLUS I cannot even imagine adding another 10lbs to my frame. 


Lemily
on 6/10/14 4:37 am
VSG on 01/16/14

I went to a pulminologist who was covered by my insurance. Then they ordered the sleep study, which was then covered by insurance. You may want to try that route first before going right to the sleep lab. I just had to pay normal copays.

    
NatalieKelley
on 6/10/14 4:40 am

It seems like this place might be like that. I have Cigna and apparently for the consultation I only pay my normal copay but I'm worried about the sleep study.

Lemily
on 6/10/14 4:58 am
VSG on 01/16/14

They will tell you before hand whether its covered or not. I had to pay the standard $50 for testing and that was it - different insurance.

    
TruemansMom
on 6/10/14 4:41 am
VSG on 06/24/13

nah, you don't want to gain weight just for insurance coverage. (some would consider that insurance fraud) They always want to meet you before a sleep study. but if you snore you may very well have sleep apnea and that would get you a co-morbidity! so worth it. The list of pre-op tests can be long, depending on your surgeon. Don't get discurouaged now, this process can take a while and the hoops you have to jump thru will either make or break you. Decide up front how bad you want it and just keep going until you are there. Post surgery you will need that determination to deal with all the changes needed to succeed!

 

Jan D.  5'-8", highest wt 231, surgery wt 213

    

    
NatalieKelley
on 6/10/14 5:06 am

I dont mind jumping through hoops! I'm just afraid of the denial :(

Lemily
on 6/10/14 5:08 am
VSG on 01/16/14

If a doctor order's the test you should be ok. Why dont you give cigna a call just to see. Usually, they (the big companies - i have blue cross blue shield) require it for bariatric surgery.

    
Gwen M.
on 6/10/14 6:41 am
VSG on 03/13/14

Don't go borrowing trouble, eh?  You'll worry yourself sick!  Just keep doing what you need to do and cross the bridge of denial if you happen to come to it.  

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

50shadesofsleeve
on 6/10/14 5:09 am

I worked 4 years to get approval ( Etna and Blue Cross) w/BMI from 39 to 41 no health issue and was denied every time. Then upon recommendation from my daughter who is a nurse,  who had VSG last year and works for a Doctor said " Why don't you go to Mexico"?

Here I am, 2 weeks out 5/26 surgery date, lost 25lbs and it cost me $4500 plus flight flight . They actually repaired a hiatal hernia and so had to pay additional $500 ( US surgery cost 10,000 est). I am 54 , single female and went alone. They even put me in touch with a surgery buddy so we emailed each other for months ahead.Met at the airport and so was not scary at all.

Take your health back from insurance companies,  either fight or look at other options.  It worked for me.

 

 

 

 

Flygirlmedic
on 6/10/14 8:21 am

My BMI was 40 when I went for my consult. No co-morbitities either. I had the sleep study done as well. Insurance covered it. I was denied by my insurance because my BMI had not been like that for at least 3 years. I did the self pay option. My insurance covered the hernia repair and all I had to pay was $5600 to the surgeon. I took out a loan with Care Credit and I pay $140 per month.

It was so worth it. I am 15 weeks post op and feeling great. I have lost just shy of 50 pounds and I am feeling more and more like my old self again before I had gained all the weight.

It will be worth it for you too. Hang in there. Take it one day at a time.

                                                                                                         

             

 

VSG 2/25/14 Dr. David Kim    HT 5'5" 51yo SW 230 CW 170.2 GW 135

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