DS Surgery research - how does traveling work with Insurance requirements?

Hello all,

I am back after 12 years... had a LapBand back in 2005 and it worked initally then it failed me. It slipped and had to be removed. Saying my original surgeon was AWFUL would be an understatement. I went to another surgeon to have it removed and she actually wrote him a letter saying that I was a "non-compliant" patient. Who does that? Long story short...I felt so bad about that, even thought my removal surgeon told me that it was basically installed incorrectly.... I still felt it was my fault. So here I am a decade down the road and at my heaviest weight. I have recently developed Acute Pancreatitis and NAFLD. I have Fibromyalgia and am in constant pain and every doctor I see tells me it is all because I am overweight. So enough is enough!!! In doing research I have decided that DS is really the only option for me to loose a great amount of weight and keep it off long term. I know have a better support system and a great determination to succeed. But am at a loss as to how all this works with having to travel to the actual surgeon. I live in Maine so there are no surgeons that perfrom DS anywhere close to me.... my insurance does cover WLS as long as I jump through all their hoops...which I am fine with doing as I feel it would be a very good refresher for me and ensure my success...but how the heck does all that work when your surgeon is 6+ hours away (that is the closest....still researching which Surgeon to go with...) Everything I have read so far is only self pay and I don't want to go there if I can have my insurance cover it... Does anyone have any experience and advice that they can share? I would really appreciate it!!! Thank you :-)

Surgeons cut and very few are involved in your care years postop. As long as you stay close by for as long as your surgeon recommends it, you are good. My sister and husband had theirs done in Spain and we rented a condo on the beach for 2 weeks after surgery. It was almost like a vacation!

Maybe I should go to Spain for my DS instead of Chicago... >.>

Dr. Baltasar retired. Sorry. But I believe Himpens in Belgium is still an option.

I think anywhere I go will be like a vacation since I am so far away from everything up here LOL. I think my question is more about Pre-Op insurance requirements like a 6 month non-surgical Weight reduction regime. a psychiatric profile to ensure I am able to follow up with the WLS regime, that my expectations of the surgery have been addressed; and That I have been accepted as a surgical candidate, that my treatment plan includes pre- and post-operative dietary evaluations and nutritional counseling as well as counseling regarding exercise, psychological issues and the availability of supportive resources when needed. So it sounds like I need to do some of this locally and have the surgery in another state. How does all this work?

Just make sure the professional you suggest is OK with your insurance and your surgeon. And keep records. Your surgeon's office will probably help you get everything scheduled. And sometimes you can do stuff like the psych clearance and diet stuff by phone if they wish.

But, but but, . . . Maine IS Vacationland! Why would you leave Vacationland to take a vacation somewhere else?

You should be able to do all the pre-op testing and meet the insurance requirements with your local doctors (as long as all the paperwork, etc., is also copied to your DS surgeon). If you have to travel you may want to look at Dr. Elariny in northern Virginia (just outside of DC). He's one of the top DS doctors in the country.

the answer to your question is that you are going to spend a LOT of time on the road. You will likely have to go once a month for your weigh ins, those can't be done on the phone.

you may be able to get some of your other required spots done on the days you are there for weigh ins. That is going to involve a day driving there, a day with appointments and a day driving home. That includes two overnight hotel stays, so three days minimum off work every month.

also, whoever you use will be billed as out of network, so you will still be pAyong a lot. It might be cheaper to go out of the country given all the logistics.

There is a very good chance she will be able to do this through a local doctor rather than travel.