surgery

I am seriously thinking of having gastric bypass surgery. Has anyone gone through Personal Care HMO? When I called them, they said if it was medically indicated and my doctor would have to call and have them send a form and he would have to fill it out and then talk to me. How long are you ususally off from work when you have this done? Some of the doctors that do this surgery in Springfield don't take Personal Care. I've tried all kinds of diets but with some of my health problems it's almost impossible to excercise. Thanks for listening.

hey theresa i don't know about hmo's i have a ppo and my process started in Jan 05 and i am scheduled for may9th. i felt that the whole thing did not take long at all. my advice is read your policy and know it well. then attend a seminar in your area and follow their proceedures. most insurances do require it to be medically neccessary, but your surgeon should take care of getting that done for you. i am expected to be off work a total of three weeks. hope this is helpful and good luck. rach

Therese, Your PCP can make the determination of medical necessity -- it doesn't have to come from the surgeon. Also, your HMO should have a listing of doctors and partner medical centers who accept your insurance. You can use that to help you find a surgeon. You may need to look at having your surgery outside of Springfield -- I know there are people who have traveled to Chicago for their surgery and are doing just fine! For the record, my surgeon recommended 3 - 6 wks to recover.. I took 3wks off and was back to work full time (I work at a desk job) when I returned. Please keep asking questions.. the people on this board have a boatload of information and are always willing to help. Good luck! Stef Lap RNY 11/12/04 390-> 300-> 175