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the question is not which insurance company will cover surgery as all will if deemed medically necessary, the question is not how many surgeries you have had either will not pay, it really is that simple. I dont see anything in your post about your reasons that you had for conversions and you are asking for conversion #3 with no mechanical failure if I understand correctly? This will be a very hard sell, even for an attorney, hope you find answers real soon
Hi airbender, I know it's been about 3 years since I've been here. Sorry for the late response.
My Reasons for the conversion of the Lap Band to the VSG:
1) I did not get the results I thought I should have. I lost weight about 20 lbs and then gained it back. Kept throwing up my food and could not get a sweet spot on the level of fills.
2) Acid Reflux was getting worse. BCBS Federal did cover the LB.
My Reasons for the conversion of the VSG to the RNY:
1) My Haital Hernia has become severe with Acid Reflux just about every night with coughing and burning sensation that lasts for hours. It has become worse and has made me even more depressed.
2) Need to lose weight with the Gold Standard Surgery (RNY). I have High Blood Pressure, Type II Diabetes, I am 5'1" and 190 lbs. I have Heart Attacks and Strokes in my family history. BCBS Federal did NOT cover the VSG, I did Self-Pay for the removal of the LB and the VSG.
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Virgie Tschirhart
Lap Band - 2008, Sleeve - 2009, RYN - 2017
Started Program Weight July 13, 2017 - 194.2
Before Surgery Weight December 27, 2017 - 185.0
Current Weight - February 2018 - 161.0
My Viva Medicare Advantage Plan ( ALABAMA) covered my complete gastric bypass just like most Medicare will but you have to go thru 6 months of testing losing some weight and nutrition classes to prove you will be compliant and successful! Out of cost pocket was only 240$!( co- pay)! ??
Just found out today that I may qualify for Medicaid in KY. Does anyone know the requirements for the sleeve procedure in KY with Medicaid (dr supervised diet, etc.)? My current BMI is 44.9. I am insulin resistant & have pcos (on metformin). I lost 62 pounds on my own through mostly exercise & diet in 2016. But since the beginning of the year I have started putting it back on. I am up 14 pounds total.
Any info on requirements would be greatly appreciated. Thanks :)
Another option is possibly going to Mexico for surgery. It's typically about $5000 plus travel expenses. The only thing I would caution is that not all surgeons deal with higher bmis, so you would need to mindful of that and ask the right questions.
on 5/11/17 5:43 am - St. Augustine, FL
I'm newly on Medicaid and I'm checking into the possibility of WLS. I've already looked through the forums and checked with the only one I was able to find that looked like they would do it, DR. Dominguiz in Covington, but the patient advocate said he only does it for patients in Saint Tammany or Washington parishes which sucks because I'm in North East Louisiana.
Guys, I'm over 400 pounds and I feel like I'm at the end of my rope as far as weight loss goes.
If any of you know of anyone else I can check with please please PLEASE help me.
I have Anthem Healthkeepers through my job but they do not cover any obesity surgery. I have been to a seminar and called a local surgeons office. The visit is over $230 and the surgery is quoted at $15,000. I am currently considering CareCredit, GoFundMe, a WLSFA grant, or charity care through the hospital. I do have a BMI of 65 and several Co-morbidities. Any suggestions or advice about what kind of next steps to take would be appreciated. Thank you!
visit a bariatric clinic and ask them what plans they accept. When I went for the introduction seminar I found out my insurance at the time didn't cover it ... but they had a list of all the insurance plans they did take ... so I waited for the next enrollment period 9 months later and switched. 8 months after that I finished the required appointments and tests and got approved, my surgery was a month after that.
Im currently going to Loyola medical center to get a bypass-revision, my medicare insurance is Aetna better health i have to go for six months don't gain weight, andi have to keep a log of my eating and exercise and submit it to the nutritionist every month... what did they say the reasons were for non-compliance?
Hello, I'm new to this but I have so many questions if anybody can please help ? Well I have IEHP, and I've had to do 6 months of weigh****chers and I've had to check in with my primary doc once a month, I didn't do good @ weigh****chers I gained and I lost, can that be a problem? My consultation with a Bariatric Doctor has also been approved.. They gave me an appointment to attend an informational seminar first, mailed me paper work to take for that day and said after that seminer I would get to have a "face to face" lol appointment with the Doctor SO.... Does any of this sound familiar to anybody??? If so what should I expect next? Will the 6 months of weigh****chers (and being supervised by my doctor) be enough? And how long will it take for me to finally get my lapband surgery?
Hockeymom87 · 0 replies · 602 views
