New here.. ?'s about insurance and Vertical Sleeve Gastrectomy (VSG)

 I am new to this group. I am a 33 year old single mom of two. I currently weigh about 290. Family history of diabetes, heart disease etc.  I am going to be applying for weight loss surgery soon and am very interested in the VSG procedure. Did you all have to have 6mths supervised dieting?  I didnt follow up last time I went over a year ago..the Dr made it sound like if I made a list of my dieting attempts over the last several years he would just send that into the insurance company (bcbs of Nd) and get the ball rolling.. I know it will take work but I cannot wait to start this journey and get healthy again..and a positive self  esteem would be great too!! I would appreciate any and all advice.

Hi there!  I haven't had my surgery yet, but I can tell you what I know about our dr's here in CO and what my insurance says.  I have BC/BS of GA (my DH works for Coke), and I know every state's BC is different, but I don't have to have a 6 mo medically supervised diet.  I went to a surgeon in Feb, and will have a consult w/a different dr in a couple of weeks.  Both just want to know what my dieting history has been in the past, and they'll just submit it to the insur.  The first dr wanted me to bring something to show that I went to LAWL, even thought I hadn't been there in over a year.  This new dr doesn't even want that...he just wants me to write it down.  I believe I should be approved pretty quickly. (you could take a look at my profile to see why I'm going w/a diff dr if you want).  Anyway, I think the insur co's are getting better about not making you provide all this documentation of diets and crap.  I'm from ND originally, and I can tell you when I looked into doing an RNY almost 10 yrs ago, BC/BS of ND wanted 6 months of documentation of PAID weight loss attempts (like WW or something similar).  I couldn't figure out how to pay for the surgery at only 21, let alone be able to pay for yet another diet that would fail first.  So I gave up on the whole idea then, but I think the insurance co's have made progress since then.  Now that's not all the insurance co's, because I know there are lots of people on this board that have troubles w/getting approved.  But I know BC is usually pretty good about it.   HTH.  So where are you in the process?  Hope it's going well for you.  Do you know what surgery type you will have?  I'm planning on the VSG...are there any dr's in ND that do that?  Hope to talk to you soon~ *Angel 

Thank you for your response. Glad to hear that you didnt have to do ANOTHER six months of dieting..god knows we have been doing this awhile. I plan on writing everything down and submiting it to my Dr in the next week. So far the VSG sounds like what I will go with. Im kinda scared and exicited all at once...I just know how much my life would change for the positive if I could lose this weight..and keep it off :) Andrea

Andrea, I have BCBC of ND and i didn't have to go on a 6 month diet.  I had to type up a letter stating the weight lost programs that i've done in the past 3 years. I included all my history of weight loss from high school on up.  Which Doctor have you chosed?  I went with Dr Schmit from Mid Dakota Clinic in Bismark because he comes to Minot once a month.  I chose to have the lapband surgery and don't know much about the VSG prodedure.  Good Luck and just PM me if you have any questions.

Awesome! So glad to hear you did not have to have six mths supervised dieting!!  Im working on my letter and will have my local Dr. submit it to my insurance. Does it take long to find out if you are approved??  I sound so impatient!  I cannot remember the name of the Dr. should I chose the VSG procedure..but he is in Bismarck.  What do you think of the lap band?

For me the Lap-band what the only surgery that i wanted...I knew a few people that had gastric done and had a number of complications that i didn't want to go near...then there was the quick recovery time with the band...I had surger on thursday morning at about 8am surgery only took 30 minutes...then by 1:00 I was on the road back to minot...I slept most of thursday (other then when my hubby got me up and walking) and friday...but saturday i was done with pain meds and wanting to get out of the house...I returned to work on monday and have had very little problems...I have a small part of my port incision that is opened and i'm meeting with Dr Schmit on monday so he can take a look at it...I don't think it's infected but want to have it looked at anyway...My husband has asked me if i would do it again and i've already told him it's do it again in a heart beat...I still can't get use to the feeling of eatting a little soup and being full...or eating a small bowl of cottage cheese and having to put it in the fridge for later because i can't fini****I don't  ever remember being full...I remember what it was like to be stuffed but not full or satisfied...I have made the mistake of still over eating...but that's only happened once...and i was still on the liquids so i don't think it was that bad...I'm sure my NUT will not agree with me... I think we each have our reason for the surgeries that we chose...what will work for one person may not work for the next person...We all have the same goal and our own way of reaching it...I think it's amazing how they do have so many different WLS option for us now that they didn't have 10 years ago...

Andrea--as far as I know, Dr. Schmit at Middakota in Bismarck is the only doctor in the state that even does the procedure. I'm currently going through a few hoops right now for the VSG too. When I initially talked to the surgical coordinator a couple months ago, she told me that the VSG is not covered by BCBSND because it is still considered experimental. For me, it doesn't matter either way because I don't have any insurance so I know I'll have to fork over the $14,125 for the procedure. If you want to PM me, I'd certainly be happy to exchange info but additionally, I highly recommend going over to the VSG forum and read up. Really a nice group of people on that board, and always willing to answer questions and support each other.

Oh I wish I could remember the Dr.s name.. Schmit would do my surgery should I chose lapband but the Dr. mentioned another surgeon should I chose the other procedure..and he is in Bismarck..but of course I do not remember. I'll have to read more at the other group too..still have to write my dieting notes and set up a apt. with my Dr. so he can get a letter off to insurance..Im a terrible procrastinator :) Ill also check into the insurance thing more..Ive heard that they dont approve and that they do..have to find out so I can decided which procedure I even want done..Initially I thought lap band but Ive heard so much negative lately. Thanks for replying to my post..Im sure Ill have more ?'s soon

Hi I had the vsg done and love it. I know that the doctors in Fargo and Bismarck are training for it right now. I had mine done in Mexico. Any questions pm me. Steve