Worried about denial from Empire BCBS do to Hypothyroidism

amurillo04
on 2/17/16 11:10 am

Hello all, I am new to this forum and I am in the process of trying to get my insurance to approve my Gastric sleeve.  I have to do a six month diet along with an UGI and blood testing.  My biggest problem is that I may be denied for having hypothyroidism as they might blame that for my obesity.  Has anybody been denied the surgery because of that even though its regulated by pills?  As long as the blood test my coordinator gives to the insurance says my TSH is fine should I be ok?

Sparklekitty, Science-Loving Derby Hag
on 2/17/16 11:52 am
RNY on 08/05/19

Two things to do:

  • Talk to your surgeon and ask if s/he has ever had patients denied for this reason

  • Call your insurance company and ask them if your condition is listed as an exclusion for coverage

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

amurillo04
on 2/22/16 7:51 am

Thank you, I called my insurance already but everytime I talk to someone they seem so uninformed about WLS.  One person said they don't think there's any exclusions.  "I don't think" is an acceptable answer in my opinion coming from the actual company.  I will ask my surgeon as well.

thallnc
on 2/17/16 12:50 pm - NC
VSG on 02/18/15

I have had hypothyroidism and been on medication for 15 years. This was not an issue with my insurance for the VSG surgery. Just check with your insurance company to see if there is an exclusion.

Height: 5'5" HW: 278.2; SW: 268.2; CW: 175.6

FuturePinUp
on 2/17/16 1:22 pm

I have hypothyroidism and it never even came up during my insurance pre-qualifications. I am also positive that some of my weight gain was due to my hypothyroidism not being properly regulated. Now that I have had the surgery, my thyroid has actually gotten even more sluggish, and my medication had to be increased, but I am still losing at a great pace.

VSG: 06/24/15 // Age: 35 // Height: 5'10" // Lost so far: 190 lbs

HW: 348 (before 2 week pre-op diet) // SW: 326 // CW: 158

TT/Lipo & BL/BA: 07/21/17 with Dr. Reish (NYC) BL/BA Revision: 01/11/18 with Dr. Reish (NYC)

Unconventional Sleever & Low-Carb Lifer

obioxiupa
on 2/18/16 11:18 am

Future pin up-  its interesting to hear that you have had this experience.  I have thyroid issues also, and have had doctors tell me they think that the thyroid will get better after surgery.  Its good to hear others experiences so I have some background as I go through it once my surgery is scheduled, hopefully soon.

 

 

FuturePinUp
on 2/22/16 12:20 pm

My doctor did mention that as the body loses weight, the thyroid can go up/down and act sort of funky while losing. They monitor it every 3 months while in my losing phase.

VSG: 06/24/15 // Age: 35 // Height: 5'10" // Lost so far: 190 lbs

HW: 348 (before 2 week pre-op diet) // SW: 326 // CW: 158

TT/Lipo & BL/BA: 07/21/17 with Dr. Reish (NYC) BL/BA Revision: 01/11/18 with Dr. Reish (NYC)

Unconventional Sleever & Low-Carb Lifer

amurillo04
on 2/22/16 7:52 am

Thank you, did you have to get your tsh tested and they never brought it up or did you not have to test it at all?

FuturePinUp
on 2/22/16 12:18 pm

Didn't have to have it tested at all. My thyroid gets checked already like every 3 months, so I put down I was taking levothyroxine, but they didn't test it prior to surgery as part of approval. 

VSG: 06/24/15 // Age: 35 // Height: 5'10" // Lost so far: 190 lbs

HW: 348 (before 2 week pre-op diet) // SW: 326 // CW: 158

TT/Lipo & BL/BA: 07/21/17 with Dr. Reish (NYC) BL/BA Revision: 01/11/18 with Dr. Reish (NYC)

Unconventional Sleever & Low-Carb Lifer

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