Intro

Greetings.  I'M in the insurance process for the DS.  In 2014 I was approved for a vertical sleeve.  I was into the final blood tests when I was hospitalized for blood clots in the lungs.  I was cleared for surgery in July of this year by my PC.  I met with my surgeon last week.  

His stats are not showing great results with high BMIs and the sleeve.  I have one shot at surgery and with the advancement of the DS surgery, I agreed to it.  

Right now I am waiting on insurance.  I hope I don't have to do the full 6 month diet, shrink exam etc.  We will see.

Anyway, even though it's a new forum, I'm glad to be back on the site.

Good luck!

If the insurance denies your request, have your surgeon resubmit. It may take 1 or 2 tries but they usually cave in eventually since they don't want the liability of going against your surgeons recommendation. Mine went thru after 2 denials and required a surgeon consult with the insurance company which most of the WLS surgeons are used to doing.

Good to have you here. Good luck!

--gina

Glad to have you with us.  If the insurance company requires the diet, psych exam, etc...don't think there's any way around it, I'm afraid.

Valerie is right, the psych eval in particular is almost universally required, and many plans require 6 or 3 months medically supervised diet or something similar. Get a copy of your EOC (evidence of coverage) for yourself and see what is required. Don't trust anything some insurance company employee tells you over the phone, read the policy (YOUR policy, not some generic "major insurance company") for yourself.

Larra

It might be possible you won't have to do the supervised diet and psych eval AGAIN if you did it last year for your VSG approval. If you're going to a different doctor than your 2014 Sleeve approval, have your new surgeon office request the records needed to be approved for VSG. Should save you some steps!

What they all said.  Welcome.

Pete

Thank you for the welcome.  

I'm not worried about being approved.  At 350 pounds, high blood pressure, diabetes, back and hip problems, I'm medically in need.  I just don't want to go through another 8 months of hoops that I went through in 2014.  But if I have to, I will.  I just want the weight gone.  I'm so tired of the 24/7 pain, not being to buy clothes in town, cross my legs, trim my toe nails on my right foot without my hip screaming.  Most of you have been there, done that, and living a better life.  I'm a prolific poster.  I had the band in 2002-2005 and lost 200 lbs at that point before it had to be removed.  Fortunately, my retirement in 2009 made this surgery possible as its a different plan than active employee and the single surgery clause starts over.  I used this website and a couple of the yahoo groups that were available back then.  I know support, both live and online is necessary for success.