Question..Please help

Hello All! I am from Chillicothe Ohio. I am really wnating to have surgery done. I am going to make an appointment to schedule a appointmnet with my family doctor this week. I am scared I do not know what to say! I have two insurance one we are excluded from the suregry it is UHC. This is from my hubsand employeer. The other is from the state, Caresource. (We have jobs, just don't make alot of money, he is a teacher and I work part time while attending school and raising 5 kids!) Anyway I spole with my insurance they will cover the suregry but.... it has to be medically necsary. As of right now I am boarder line high blood preasure. I am 25 years old and weigh 265lbs and I am down from 305. My weight has set me into depression bad! I hate being over weight. I am scared of what would happen to my childern all under 7, if something was to happen to me. So I was wondering if anyone has used Caresource to pay for their surgery? I also wondering if anyone has advice on what I should say to the doctor! I hope to hear from you guys!! Has anyonw

I had UHC when I applied for insurance approval. Have you decided on a surgeon yet? Most insurance carriers have a criteria of what they want before approval. I would call my bariatric surgeon's office and they can guide you through the procedure of insurance hoops. Most of them want a letter of approval and necessity from your primary care physician and a physical. I agree that it is a long and scary process but the end results more then make up for all of the aggravation. I know that depression played a huge part in my obesity. Who wouldn't be depressed when you can't do anything bu****ch the world go by you? Start with your Primary Care and ask him/her for the name of a bariatric surgeon if you haven't already decided on on. Then get ready to start jumping through hoops to get approval. Don't let the insurance company get you down. Most bariatric surgeons have qualified people to do that hoop jumping for you and know what to expect. Hang in there, you'll be glad that you did. Oh aand if you need a WONDERFUL CARING surgeon, may I suggest Dr Curry? He did mine and I couldn't have had a more caring and compassionate doctor. He is in Cincinnati, but well worth the drive to know that you are in the safest hands possible. Feel free to contact me if you have any more questions or concerns.

Hi neighbor - I don't know about your insurance situation but I can say that Dr. Schumacher's Office is the best (IMO)! They will help you step by step with your insurance and your situation. All the ladies in the office there are more than willing to help with what ever they can and they do not charge a program fee - I started out with Dr. Curry's Office they charge a $300 program fee. Best to you on your journey!

Yes we are neighbors I actually live in Pike Co. I live on Hay Hollow Road. Where is Schumacher's office? Who was your family doctor? If you do not mind to tell, and what insuarance did you have. YOu can tell me it is none of my business if you like! You can email me if you like [email protected]

No I have not talked with a surgen yet, I am callin tomorrow to make appointment with family doc. I do not think he likes the weight loss surgery so I might be at a total loss after I see him~ I think it is a exclussion under my UHC butt I been told caresource will cover it! I called them and they said if it is medically need. I do not think mine wil lbe, but I am going to give it a try!

Hi Tony There are tons of PCP's that just don't get this surgery. But today we are finding there are more changing their minds. I believe it has a lot to do with the changes that have been made within the Bariatric community over the last few years. For example, because of the center of excellence many are upgrading and perfecting how they teach, pre as well as post op care. Psychological care is so important..you aren't just sent to one for a quick "is this patient ok to have surgery" type thing..but many are within the centers to help you through changes. Along with some awesome dieticians I have had the opportunity to meet. However, if your PCP will not give you his or her ok for surgery, then please seek one who is..your aftercare is so very important, surgery is only a small part of the process..this is a life changing forever kind of decision..so your PCP must be in this for you for a lifetime as well. As suggested here seek out a good surgeon and program. Attend free seminars to get a good feel for the surgeon as well as their staff, ask questions!. What type of program do they have? Get details about things like hospital stay and how well the hospital staff is trained with bariatircs..what type of education before and after..how involved is the surgeon in your recovery and after care for life..all of which I feel are very important reasons to chose a program. Once you have a feel for a good program talk to them about your insurance and your need for help getting approved. A well trained and dedicated staff will work hard for you..it could take some time as was mentioned but as Cathy said, it's worth the hard work and wait in the end. I am very privileged to have met and spend time with some awesome surgeons. two of those mentioned here as well as Dr. Rodriguez who has been posting information and of course my friend Dr. Sonnanstine in N. Ky.. So where to go and what to do? Though I see nothing wrong with traveling to a good surgeon, I have such strong belief in after care my suggestion would be to see first if you can find a program nearby..See what information you can get about the surgeon, his training and experience..is he full time bariatrics, a medical director of the program is a HUGE PLUS!..Every medical director I know is very involved in the program and with the patients...you can find that out by asking the right questions.. With small children you want a place where you can attend after care support meetings, as a mother of two beautifull grown kids ( and soon to be a granny)..I know it wasnt' easy to find time for me..Remember that WLS surgery must be about you..not the doc, not the family, not the world..for the first time in your life this is about you, for you and a few short hours a month after surgery you need to take time out for support, reflection and fun..all those things are found in support meetings and seminars..I attend many to keep up on the latest and to keep in touch with the professionals as I did at Deaconess when I met Dr. Rodriguez last Sat. I also attend a class once a month with Dr. Sonnanstine and I trained as a patient advocate with him for over a year attending surgery and speaking to his patients..I have met and talked to Dr. Schumacher in Dayton, where I also attended surgery,as well as attended his group meetings. Today I have a meeting with Dr. Inge who performs bariatric surgery on adolescents at Cincinnati Childrens Hospital...I work as a patient education advisor for Bariatric Advantage, (vitamins and supplements) with this I spend time with many programs dieticians as well other clinicians.. again it's been a great privilege and I do these things hoping that I can help others who are seeking information about good programs. If there is anything I can do to help you out, please feel free to contact me. Brenda