Is your surgeon Dr. Daryl Stewart?
Dr. Stewarts consult..over two hours. He answered every question, patiently. I met the nutritionist, had an eeg, the whoel nine yards. all doubts, squelched, I came out of there confident I made the rigth surgery choice, etc. The other consult di dnot even compare.
Since the consult I have found this forum and am even more satisfied with my choice. He accepts federal BCBS and his staff is very used to workign with Federal BCBS.
I appreciate you sharing with me. It just gives me more assurance about my choice of Dr. Stewart.
Are you a lightweight? I am at 187 lbs. So, I'm not sure if BCBS Federal will approve me.
Thanks for sharing.
Best Wishes to you on your WLS journey!!!
We talked a lot about insurance because right now I have another Federal Plan that has a lot longer pre op requirement for nutritional counselling, and he has dealt with Fed BCBS a lot, and said if you meet their requirements it is fairly straight forward to get approved.
There Are a list of requirements but the one that would effect you the most is the following requirement:
Diagnosis of morbid obesity ( as defined by an individual with a BMI of 40 or more or an individual with a BMI of 35 or more with one or more co morbidities). I do not know what your height is but if you are taller than 5 feet your BMI will be 35 or less, if you are 5 feet with anothe co morbidity it appears you would be covered.
they also have requirements that have to be met if you had a previous weight loss surgery...I do remember doctor Stewart saying the requirement are so vague it is almost impossible to meet. One of the requirements is weight loss from initial procedure was lass than 505 of excess weight and patient was compliant with previously prescribed post operative nutrition and exercise program (that one is the kicker, unless you have impeccable food journalling and activity journalling).
But you cold go to the web site, research the requirements and call BCBS yourself to get the answers as well.....I will even do half the work for you and provide the link. There are phone numbers in the brochure you can call as well.
http://www.fepblue.org/
Thanks again!!! Best wishes to you!!!
on 11/8/11 9:10 am - TX
Dr. Stewart was my doctor, I was a LB to DS. My insurance didn't cover it because my BMI was to low but it was worth every penny. I am 2 and a half months out and have lost 31 pounds, I started at 220 and am losing slower but I only have 50 to55 to lose. I am still losing just slower than someone with over 100 to lose. I would do it again in a heartbeat and would use no one but Dr. Stewart.
Hi Jeepfarmer,
That is what I'm afraid of not being approved. I guess I will have to see what happens.
I wish you the very best on your WL journey. I'm sure you will get to your goal in due time.
Thanks for sharing!
My weight when switched was 251 (I'm 5'7 or so).
I now weigh 138 - total of 113 lost so far. I'm not even a year out yet!
My insurance did cover the DS but I did have a laundry list of prereq's to go through to get it. I had Aetna and was approved the first time.
You already have the VSG so you would not pay the whole cost of the DS, at least in my opinion. He would just do the intestinal part. I would think you'd pay around $13K or so for that but I coudl be wrong! He may or may not want to revise your sleeve depending on the current size. That's something to take into consideration. I believe he uses a 31 French bougie.
I was a virgin DS'er and my surgery took 2.5 hours. I was up and walking a few hours after surgery and off all pain/nausea meds a day before I left the hospital. My mom drove me home once I was released. I spent 3 days in the hospital.
This has been the best decision I've ever made. I do hear, though, that revisions tend to lose more slowly than virgin DS'ers. More food for thought. I coudln't love Dr. S and his staff any more though. They are wonderful.
Hi MarcyMad,
You are doing excellent!!! Congrats!!! I am not really sure if he will do the DS on me. Just found out that since I'm an older VSG (2009) my results might not be to good. I'm a lightweight and I'm not sure if BCBS Federal will approve me. I have heard nothing so far but GOOD things about Dr. Stewart!!!
Thanks so much for your input!!!