??can anyone from mass help me??

I had a failed bypass in january 06 d/t meshing and md unable to get enough intestines. Then ended up with a severe infecton from the heprin shot so mds feels it wouldn't be safe to do banding and that my last hope would be the vertical sleeve. Problem is I have Mass Health and the md isn't sure they will cover. For the fact it isn't a surgery that is done as much as the bypass or even the banding. Is there anyone else out there in my situation? Does anyone know if Mass Health will cover? They were great about the bypass surgery but I am worried about this. I am so depressed over this whole situation. Can anyone help? THANK YOU! Cathy (Western Mass.)

Dear Cathy, hi, my name is Deirdre and I'm from Worcester. I dont mean to sound stupid, but is Western Mass like Springfield? If so, have you tried calling Mercy Hospital? I almost went there for my WLS but it was too far to drive. I think the surgeons' name is Fiallo. his last name. I wish I had some answers for you but I haven't even had my surgery yet. i'm scheduled for jan. 16. i wanted to respond to you so you wouldn't feel alone. i don't know how many people go into the Massachusetts board but maybe if you tried the same question on the main board you may get more answers. you may have to travel also to get the help. there's all kinds of wonderful advise and websites for people who don't have money. look into it and if you want to talk...email me anytime. remember, your special and i pray that you will do good. (((((((((((((((((hugs)))))))))))))))))))))))0

I really can't help BUT there is a Vertical Sleeve board on here. Go to forums at the top, and click on Vertical Sleeve. Good luck though!

You would need a letter from your MD/Surgeon stating why you need the procedure. A letter of medical necessity. If you are denied there is an appeal process. I have dealt with the mental health division in my job. Sometimes it comes down to finding a person on the inside to help. If you do have the surgery make sure that you prepare any site that you need to use for injections well with an antibacterial soap then follow up with alchol swab. If you have a problem with yeast make sure to use you have nystatin available. Good luck with the process. Sean

I work in a different insurance company but have friends that have dealt with Mass Health in the past. It's a long, long process but can be done. You definitely need the letter of medical necessity ASAP. Copies of your past medical history documenting the failed surgery and reasons why the lap band is not an option. Keep copies of everything for yourself. Call the insurance company and find out exactly who to send the info to. Send it in and wait. If you get denied educate yourself on the appeals process and find out what you need to do. If you keep plugging away you can wear them down. I wish you the best of luck! Kathleen