Question:
Apparently I have a failed surgery with no insurance need advice?
I had a VBG in June of 2002. I weighed in at 303 and now weigh 250, thats a loss of about 50lbs in 1 1/2 years. I am beginning to see the scale creep up. My states Vocational Rehabilitaion paid for my surgery, I have no insurance. I started complaining to my surgeon about the excessive amounts of food I could eat within weeks of surgery. He blew me off until about May of this year. He said it sounds like a staple line disruption and wants me to have an upper GI. Voc Rehab will not pay for the test and I can't pay for anything out of pocket! My surgeon said "don't bother paying for the test yourself if you can't pay to get restapled". I just feel like I'm getting screwed and I don't know if there is anything I can do about it. What would you do? I'm not asking for diet or exercise plans, if I could do that I would've never needed surgery. My surgeon told me I have a failed surgery. — LaKeAffy (posted on December 29, 2003)
December 28, 2003
Dont feel bad, my surgeon says the VBG failure rate is 80% over 5 years:( I
fail to understand why surgeons continue doing this surgery since it has
such a bad track record. How about getting a job that has insurance that
pays for WLS? Like home depot? Its sad your surgeon is setting up people
for failure.
— bob-haller
December 28, 2003
LaKeitha,
I've got several friends who were conversion surgeries from VBG to DS for
this very reason. There's a Yahoo group where you may find some support
and information - the URL is: http://groups.yahoo.com/group/DS_Revision/
If you need email addresses of people who have gone the same route you
have, let me know, okay?
Is self-paying for a conversion surgery a possibility for you? You'd be
amazed at how affordable it is - particularly if you own a house or have a
retirement savings - it's tax-deductible, as well, and if retirement funds
are used, they can be taken without tax penalty in many cases. For more
info, see www.bodybybaltasar.com
Many blessings, dear one!
dina
— Dina McBride
December 29, 2003
But if the test were to come back would they pay for the surgery? I would
see if Medicaid or some other agency can help also.
— snicklefritz
December 29, 2003
It should fall back on Voc. Rehab. Contact them
— sherri parker
December 30, 2003
I just had to answer Bob Haller on this one. Even "if" she got a
job with insurance, there are VERY few who would do a revision for her and
approve it after another insurance company paid in the first place. First
of all, she has obviously seen her doc about this in the past year so there
will most likely be a year wait for the insurance to even cover office
visits for this. It's pre-existing. Again, this is why I stay online and
answer some questions (aren't you all just so lucky lol). There are so
many people who had the surgery, be it VBG, RNY or DS and then for one
reason or another, have had post op problems with their surgeons. Many of
the docs just don't want to deal with them. There are soooo many good docs
out there who care, but some of us, me included, ended up with duds. Just
to let you know, mine was on the board of EVERYTHING, well known and well
respected when I went to him 4 years ago. His aftercare program though,
was a joke. At that time, I honestly didn't know the right questions to
ask before surgery. Now I do and I stay to make sure that preops ask them
and research first and formost. Even with research, these problems can
happen and some people just don't know where to turn like this poor woman.
To me, voc rehab should be footing the bill. They okayed the surgery and
they need to pay for problems post surgery. I, personally, would find a
lawyer for this. It's not right to just throw this poor woman to the
wolves and say "oh well" we did the surgery for you, now if you
get sick or it doesn't work it's not our fault". That's ridiculous!
If they thought she needed this surgery, then she certainly needs to stay
healthy for it to succeed. If it's not succeeding, they need to correct
the problem. I wish this woman nothing but luck and blessings and I hope
that you find an answer for this. Hugs
— Barbara H.
December 30, 2003
Barb I couldnt agree with you more. I was only trying to be helpful
suggesting how she could get insurance. But personally I think the VBG
should be replaced by the lap band. Its easier, reversible, and adjustable.
I also think docs should all transect because of the number of posters
here whos VBG or staple line fails. BTW these opinons are my surgeons as
well. Voc rehab should foot the cost. or the surgeons insurance since it
appears the surgery had troubles from the begining.
— bob-haller
January 2, 2004
I have been inactive on this site for quite awhile, so probably won't see
any replies or corrections to my post if anybody makes any, but I did want
to briefly respond regarding Barbara and Bob's issue, just in case there
are interested parties out there. I don't claim to be be an insurance
expert anymore, but worked at Humana for 10 years in the past so have a
little background. In most states, as long as you've had continuous
coverage (without a gap in coverage for, say 90 days or something like
that), 'pre-existing' does NOT apply as long as you enrolled for coverage
with your new employer within the open enrollment period (usually within a
specified number of days of employment, such as 30). However, this doesn't
hold true if you at first deny coverage with a new employer and then decide
6 months later that you want it. Then, all bets are off and pre-existing
conditions are not covered. Unfortunately, since the original poster of
this post didn't have coverage to begin with, this probably won't apply..
So sorry, but keep your chin up!! I had to pay for my surgery out of
pocket due to a written exclusion in my policy. I'm happily still paying
for it each and every month, because I know it was worth it and I found
ways to finance it. Where there's a will, there's a way!!
— gina C.
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