What Do I Do Now ??????????????

wings
on 12/17/08 12:13 am - Fort Myers Beach , FL
Dr. Teel and Mcgurire's office just called me and said that Anthem bc/bs ppo and medicare A and B will not cover a revision.  I cannot stop crying, I e-mailed obesity law and will hear from them in couple of days.  What do I do now, I just cannot sit and let this goes unresolved.  Please anybody anysuggestions would be appretiated.
Wings
nean
on 12/17/08 4:05 am - Tacoma, WA
I know you have your heart set on a DS and have good reasons for that, but maybe you could join us over on the VSG forum? We are cheaper  than a DS and some of the bandster revisions over there report that they are happier with the sleeve. 'Course, they were having problems other than just not loosing the weight, so that's different than your case. Your insurance will still probably not cover even the sleeve, but it is easier to afford than a DS and it is a step in that direction.

"be willing to sit in the middle of the fear and fucking feel it." Lady Raven
www.obesityhelp.com/forums/gay_lesbian_bisexual_transgender
VSG 12/9/08  Highest 278, then lost #30 preop Goal 126 

106589

wings
on 12/17/08 6:24 am, edited 12/21/08 8:37 am - Fort Myers Beach , FL
Thanks Nean
After talking with Dr. Curry the VSG was not an option that he would choose for me due to the amount of wt I still need to loose and you are right insurance won't cover it.  But Medicare will cover a DS Go Figure.  Anyway, If at the time VSG was offered by Dr.Curry I would have probably done that because the second step if needed can be done later which completes the DS.
WIngs
Katrina B.
on 12/17/08 7:38 am - Prestonsburg, KY
I would not recommend VSG as it is a restrictive procedure only and since lap band didn't work for you, you want a surgery that also has the malabsorption part also.
Keep your head up! It may take some time to sort through the insurance part.

Katrina
wings
on 12/17/08 10:13 am - Fort Myers Beach , FL
Thanks Katrina
VSG I believe is really good for people with more than 75 to 100 to loose.  If it was offered when I had surgery I truly think I would have done that one.  I do believe I will get my DS surgery and I don't believe I will wait for months for it.  It is in God's hands.
Wings
(deactivated member)
on 12/18/08 6:21 am
The lapband and the VSG are not the same surgeries. Yes they are both restrictive, but not the same. I have been revised from band to sleeve last month. The band works for about 50% of the people. I am the other 50% it didn't work for, due to too much restriction and that causes voimting, food getting stuck in my chest etc.  Sleeve is restriction, but I have no voimting and I like it way better than the band. When saline is taken out of the band, it is not restrictive at all and it's like not having any surgery done. Which leads to weight gain. So you go back and forth with fills trying to find the sweet spot. I am not sure why some people on this board believe that bands and sleeves are the same.  They are not. Hopefully this will help you and others understand this true fact more.

Sally J.
Katrina B.
on 12/18/08 6:52 am - Prestonsburg, KY
Hi Sally J.,

I never once said they were the same surgery.
It is a fact VSG and lapband are only restrictive procedures. I'm not too sure if your figure that 50% of people fail with the lapband is accurate. I could be wrong, though I am sure it's high.  It is true that when a lapband has no saline you have no restriction but the point of the surgery is RESTRICTION only; limiting the amount of food you can hold at one time.  None of your calories are malabsorbed. RNY/DS restrict food intake (volume wise) and also limit the amount of calories you absorb.. DS more than RNY of course.

I believe you have misunderstood what I wrote. NO, they are not the same surgeries, but they are ONLY restrictive, therefore do the same "job".

Hopefully people are smart enough to research..A lapband is a band placed around your stomach while VSG involves no band but cutting of the stomach. Ultimately only causing restriction.

Katrina
(deactivated member)
on 12/21/08 3:11 am - Togo

Take charge. Get on the internet and check out the 'eligibilities' for wls. if you fall in the correct range with your bmi and if your co-morbidities fit for wls then you have reassured yourself that - yes, you can have this.

next, call the insurance companies yourself. take control. if you don't get a satisfactory answer pursue them. when i called my insurance company i kept on and on until i actually got an r.n on the phone who finally admitted to me that yes i was eligible.

next, get on the internet and pursue bariatric doctors. get copies of the tests that you have had done and start sending those out - fax, e-mail, mail - get those out there.

if you know you qualift then pound the doctors doors down until you get what you want and need from them.

don't take no for an answer.

but first check to make sure that you qualify. then be relentless in your pursuit. make it happen.

                                               

wings
on 12/21/08 8:36 am - Fort Myers Beach , FL
Thank you so much,  I have started the fight and it is on.  I am doing paper work stage now and have a initial consult with a Margret Imman M.D baritric surgeon in Indianapolis Indiana Jan 15.  I am in process of getting my letter of necessity from Dr. Curry and all my medical records and blood work from last month.  Also Dr. Husted's office in Sommerset KY is working on it too.  I am waiting for papers to sign and send back to them. Both surgeons are very experienced and both will take my medicare A and B as secondary because my primary Anthem PPO does not cover WLS at all.  I am excited and I will keep everyone posted.
Wings.
Most Active
×