Introduction with Questions

Hi Everyone,

My name is Jen and I have just been introduced to these boards and directed to the lightweight one.  I am looking for some answers to some of my questions as my regular hospital bariatric program turned me down.  I have a BMI of 34, mild sleep apnea and am on the verge of Diabetes 2.  Is is common to be turned down at these levels?  I am so frustrated.  I am not expecting this to be covered by insurance (although I would love it if it would be) and I am prepared for that but I have no clue where to turn next to see if another center would perform the surgery.  If anyone has any advice that would be great.  Thanks.

I checked into self pay and was told only people with a BMI of 35 plus verified co-morbidities could have surgery self pay or not. I went to Mexico. If you are going to self pay why not save about 15,000.00. The doctors and nurses are amazing in Mexico.

good luck

wendi

It is pretty common.  I think 35 is the magic number with 2 comorbidities.  How far are you from that?  Like eat a big meal, drink a lot of water and wear heavy clothes close enough?  Seems odd that we would encourage folks to GAIN weight but if it makes the numbers work, sometimes that is one way to approach it.

There are also lots of folks to go to Mexico and have a great surgery and experience.  That is an option. Check other Drs in your area also.  Some may have different rules than others.  And be sure you don't have comorbitities you aren't thinking about, GERD? cholesteral?Blood pressure? arthritus?

Get a copy and read your insurance document so you have no doubt what they require. Mine listed the comorbidities that they acknowledged.  Once you know if you qualify with your insurance you can decide where to go. 

Were you turned down by the bariatric program or your insurance co?  I would call your insurance company and find out exactly what their guidelines are so you will know exactly where you stand.  If it was your program, try another program.  I went to a teaching hospital.

Anne

Hi Anne,

I was turned down by the hospital guidelines, I know the insurance won't pay for it.  I am just wondering if there if there is anyone who knows someone good in or around the Philly area.  Some ppl say travel to Mexico but I am just a bit nervous.  I would like to go where someone else has gone before so I can talk to them about it.  The one that turned me down was Abington Bariatrics at Abington Memorial Hospital in Abington, Philadelphia, outside of Philadelphia.  Thx.

I recognize that your BMI is 34 but how much do you plan to lose? I have no real suggestions as my BMI was 39 and my insurance covered everything. I have lost 70 pounds and am planning to lose 30 more pounds. So I was just wondering how much loss you were planning.

I understand that you are nervous about traveling to Mexico but would you be willing to travel out of state?

If you can get close enough to the guidelines, you could always go out on a few dates with Ben & Jerry. But, after, you will need to break off that relationship.

There is a place in Texas.  I have done NO research on these surgeons. So you would want to do that, but they are advertising $10,000 for sleeve surgery.  But looks like BMI of 35 is the minimum.  I am having trouble getting a revision with a BMI less than 35 (I had to have my band removed due to erosion) so I am going to go to Mexico.

From their website..."BMI of 35 or over with one or more diseases associated with obesity, or a BMI or over 40 regardless of diseases present, you may qualify. The BMI is just a rough guide however – other criteria listed above and below will ultimately determine eligibility."