HELP!!!!! CONSIDERING WLS
Hi!
Welcome to the journey! The first thing to do is find out about the differnet types of surgery, the gastric bypass being the most available and popular. The is also the lap band and the duodenal switch. Get an idea of what these are. You can find that link on the main page here.
Then, call your insurance company to find out if it's a covered benefit and what their requirements are. Most want to have 6 months supervised diet with your doctor, so you may want to get started on this. Talk to your doctor about it, he/she will have to write a letter stating that you need this surgery.
Also, begin to compile medical records and any other paperwork that you can regarding your weight and health problems related to it. Weigh****chers or Jenny Craig paperwork, for example, do help, if you have them.
Good luck in your journey. It takes alot of hoop-jumping, but it's SO worth it!!!
Bonnie B
In a nutshell, you need:
* a surgeon covered under your plan
* a referral from your PCP to that surgeon
* a letter from your PCP, surgeon and any other medical professional indicating your MEDICAL NECESSITY to have WLS.
Here is a possible sequence of events:
* Research candidate surgeons you feel comfortable with.
* Contact your insurer with specific questions to see what your policy covers. Each employer's policy is different, and many these days have a WRITTEN EXCLUSION for weight loss surgery.
* Narrow your surgeon selection based on network participation and surgery type covered.
* Obtain letters from clinical specialists such as a dietician (6 month dr supervised diet plan) & psychologist (psych consult).
* Obtain a letter of medical necessity & referral to a surgeon from your primary care physician (PCP). Note: in some cases you may need a referral from your PCP in order to do the previous step.
* Visiting your surgeon & providing them all the records they need to send. I have Aetna and they required 5 years of medical recording indicating my weight and "morbid obesity" for past 5 years.
You've come to the right place!!! Here are some sites you can visit to learn more about the surgery and the process:
http://www.obesityhelp.com/morbidobesity/WLSjourney.html
Find out what your BMI is - in order to qualify for approval for surgery your BMI must be 35+ WITH co-morbdities like type II diabetes, high blood pressure, heart disease, etc.
http://www.obesityhelp.com/morbidobesity/bmi-start.phtml
If you have any other questions, please let us know. We are here to help!!
Trisha