New - and not sure what to do.....

I have my first appointment with my new PCP tomorrow, I'm nervous .....how do you bring up the subject of WLS to a Dr. you have just met and get them to understand where you are coming from?....I am not sure if you have to even have a referral from a PCP or if you can just scheduel a consult with a surgeon? I am also worried about the approval because I haven't even been covered by my insurance company a full week ..I am afraid I may be turned down right away. If any one has any advice I would be very grateful for any help!!

Hi Melissa, I see you are from West Bend--yay, that's where I live. I don't know who your new PCP is (Mine is Dr. Jennifer George at the Aurora Clinics in Jax & WB) but don't be afraid to bring up surgery. At the time I first brought it up about 3 years ago, I was about 100 lbs overweight, so I barely just qualified for the surgery, I think my BMI was 42. She gave me the name of a bariatric surgeon and helped complete any necessary referral paperwork to see him. She was very supportive. Well, for various reasons I put off the surgery, but when I hit 120 lbs overweight a year later, I started looking into it again. Dr. George was still supportive (especially since I was continuing to gain!). I researched several different surgeons/hospitals and found Dr. James Wallace at Froedtert to be the best one (I know that's my opinion, but I still believe it to be true!). I had my surgery in April 06, have lost about 95 lbs so far, and couldn't be happier! So just go for it! If the new PCP doctor isn't supportive of the surgery and you qualify for it weight-wise, then go to another doctor who is. Please feel free to personally e-mail me with any other questions you may have: [email protected]. I'm so glad I went through it, it has changed my life. I am now a big advocate for the surgery and will talk about it to anyone who will listen!

First of all WELCOME Melissa! I agree, just talk to the PCP...let him/her know that you have been looking into WLS and what you have done in the past to try and lose weight. I wish you lots of luck in the beginning steps of this journey! Secondly- Christina.....WOW! 95 lbs! That is sooo awesome! Congratulations! Also, I see by your email, you are a teacher, thank you for leading our future leaders. Pam

Thank You for the welcome and the support!!

Hi Melissa, As a healthcare provider myself I have to say that you need to be your own biggest advocate! Do your research so that you have knowledge on your side and be assertive with your PCP in voicing your desire to have the surgery. Mine was receptive and supportive at the first mention of it. Also, call your insurance company and find out who or which department does the reviews for pre-authorizing bariatric surgeries and talk to that person to find out exactly what their requirements are. This part I didn't do but after being denied the first time around and then calling the insurance company for the first time after that, I then got all the detailed information about their requirements. Had I had that going into it, I probably would have been approved the first time I submitted my info. Good luck!

Thank You so much for the help....I just got off of the phone with my insurance company and they do cover the surgery, I don't need approval for the inital consultation ....She also told me the only requirement to get the surgery is that you are morbidly obese......OMG thank you for your help I never would have called or even known what to ask them!!

First of all - welcome! DO bring up surgery with your PCP - it is important to have his/her support for the process. I've had my PCP for about 5 years, but I am his first patient to ever have WLS. I have his 100% support and he is working on educating himself on the basics of WLS and how my care may change after surgery. I would recommend you check if your insurance has any kind of waiting period for pre-existing conditions - some do, some don't. Obesity would probably be considered pre-existing, so you will want to make sure you know when your waiting period would be over. Best of luck to you!

Thanks every one for responding, the help and support is greatly appreciated, it really helped give me more of courage I need to approach my PCP about this.   I am now just worried about the insurance part I never thought that obesity may be considered a pre existing condition is this a common thing?? Also does any one know if obesity would be a pre-existing condition if I have yet to be diagnosed? Thanks again for all the help and support!