crosswind

OH, I got my last post about this backwards. It's BCBS that's two years and UHC that's five. Sorry. Long time either way.

Thanks for posting this. When I talked to a customer service rep he said it depended how the claim was written. Most doctors won't refer to the surgery if you mention it migt be a bad idea, and a barium swallow won't raise much suspicion since it's used for all kinds of diagnostic reasons. Basically if he orders it, it's going to go through.

I just talked to my insurance rep about approval on a policy after the fact of VSG. She told me that, first of all, if my BMI was over 40 that I was uninsurable. I am *right* at the line, just under 40, so the underwriters told her that I might not be approved anyway because I may be considered too close to the line. FACT 1: IF YOUR BMI IS OVER 40, YOU ARE POTENTIALLY UNINSURABLE BY MAINSTREAM CARRIERS She also told me that if I had already had VSG and I was applying for a policy and did not disclose it at time of application, on discovery the policy would be rescinded. FACT 2: IF YOU LIE TO PROSPECTIVE HEALTH INSURANCE CARRIERS, IF THEY FIND OUT THEY'LL CANCEL YOUR POLICY IMMEDIATELY. She also said that if I was 'contemplating bariatric surgery" at the time and I did not disclose that, my policy would be rescinded upon discovery. However she also said that if t I was contemplating the surgery beforehand and I did disclose it, and they wrote the policy for coverage, later discovery would *not* mean it was rescinded. FACT 3: IF YOU ARE CONTEMPLATING SURGERY AT THE TIME YOU APPLY FOR REGULAR HEALTH INSURANCE AND YOU TELL THEM THIS, LATER DISCOVERY OF YOUR SURGERY WILL NOT RESULT IN POLICY CANCELLATION. Blue Cross Blue Shield, according to her, will not insure people who have had any bariatric procedure within the past two years. And finally: she quizzed me very carefully once I had asked her about this and she talked to the underwriters about whether or not my weight was accurate. Because I had asked about this, the underwriters were dubious that I was telling the truth about my BMI, because as far as they knew bariatric surgery is never performed on anyone who has a BMI under 40. They thought that because I was trying to get a clear answer about this I might actually be over 40 and lied on my application for general health insurance. I told her yes, it was accurate, and that in insurance scenarios you can't often get approved under 40 but as a self-pay patient being over 40 is not a hard and fast rule. The underwriters apparently did not know this and so she asked me several times if I was perhaps fabricating my weight for insurance purposes. Anyway, interesting conversation. Take what you need.

Hi Heidi: Blue Cross told me five years, United Healthcare told me two. I realized I had a COBRA policy I can opt into but the price is unbelievable: they quoted me 1,322.00 a month to stay insured, and it's Anthem so I'm not sure if they would cover anything that happened anyway. What I'm thinking is I'll just cross my fingers and pay COBRA for a couple months, and then go out looking for cheaper insurance. I remember Aetna told me that you had to wait six weeks before applying after a major surgery or pre-existing diagnosis and they would look at applications on a case-by-case basis. I don't qualify for HIPAA or CHIP because I have COBRA; if I have a valid offer I don't qualify until it's exhausted. But basically I think what's going to happen is as soon as I'm sure I'm not going to have complications, I'll drop insurance and go bare. I am *quite confident* that barring any complications I am going to be a lot healthier after this surgery. Most routine stuff -- cold, bladder infection, etc, is cheaper out of pocket anyway. Most health conditions in middle age are related to diet: diabetes, heart problems, cancer -- all of it is either entire or somewhat related to that so the likelihood of my having a heart attack or something *after* this surgery is kind of small. This is clearly the biggest risk self-pay patients face but later on I wonder who else will be stuck between a rock and a hard place, unisurable because of their sugery they got while on another carrier. I spent some time following links from an initial link that promised to have "gastric bypass insurance." All I got back was a quote screen where I could leave a name and number for agents, to call: most of them were BCBS, Aetna, etc. Not sure what they're up to there. If you're not insurable over 40 and you're not insurable after bypass, it seems what insurance companies want us to do is diet and exercise so we never bother them with any kind of bill at all.

BTW this puts me undoubtedly under 40 BMI. Thank goodness I'm self-pay.

I was supposed to start the pre-op diet ten days before surgery but I started a little early. I'm on my third day and I lost five pounds -- low carb, low fat, high protein for Dr. Aceves.

By the way I don't mind sugar free and I basically eat sugar free everything. Except normally maybe in this case, when I've just had major surgery.

Right. It just seems like, for a shorter period of time, a little sugar might help. Later when your first priority is protein it makes sense to cut carbs since the belly won't hold much food. But in the beginning for the sake of calories?

Uh, good question.

Believe it or not, I just got off the phone with a phone sales rep for Blue Cross Blue Shield Nebraska. I am applying for an affordable single policy now that I'm divorced and now that my kids have flown the coop -- and I told her I was considering weight loss surgery and I wanted to know if emergency serviices connected to surgery were covered. She said that if I had had gastric bypass surgery already, I would be considered UNINSURABLE by Blue Cross Blue Shield Nebraska. This is for gastric bypass surgery only. I told her I was not going to get gastric bypass surgery, but something called a vertical sleeve, and she said, well, that's a little different. But she did state several times that if I attempted to get private insurance after having had a bypass I would be UNINSURABLE. Just FYI. What are those poor people doing if they need insurance after their bypass?

Eh, they need ten years of history before they make a final determination. There's that for the lap band but not for the sleeve. But personally after reading all the "nonfatal' problems there are with the band I'd rather just sleeve and be done. Why would I want an "adjustable" stomach?

Yeah, with that guy we don't know the whole story. When I talked to Nina she said Ernesto's made some observations about one or two people on the way to the airport -- like one of them wanted to stop somewhere to get chips and soda....

That's what the lady said. She said there were just too many expensive complications later down the road. Good to know, eh? Although the reason the sleeve isn't covered by a lot of insurers is because it's considered experimental.

What was it like to have NO food for ten days after surgery? Did you go crazy not being able to eat? Were you starving and tempted to just say forget it and risk death to have a sandwich? Or did you not notice your hunger or any cravings for food?

Hi there. I am absolutely committed to getting sleeved as soon as is reasonably possible -- the issue is the price and I wonder if anyone could help me. I am looking at surgery from Drs. Hung and Taddeuci. The thing that sold me on this surgery was that global insurance was included in the price of 6100 dollars for the surgical fee. The local hospital charges 12,500 for all fees and an overnight stay and then the pre-op assessments are roughly another thousand dollars. So I'm at 20K. If I could find a cheaper surgeon to fly to with the global insurance to cover complications I would go there instead. This is the only reason I don't want to go to Mexico -- I don't care if its in Mexico and I'm sure they make you safe when you go, but there is no coverage for aftercare and I have no health insurance at all. In the event of complications I would be on my own with a huge bill and no recourse. Is there another, cheaper self-pay surgeon with a package that includes this kind of insurance? Thanks.

Anyone who has read about getting a gastric bypass knows that one of the most unpleasant side effects of that surgery is very offensive gas. People talk about it at their work and stuff and NOTICE it; patients are forever after having to worry if they're giving off emissions. There's now a line of charcoal seatpads and pantyliners to absorb the odor called Flat D. Do sleevers have the same problem? Anyone here?

I am SO excited!!! I just scheduled my sleeve in Mexico with Dr Aceves! ! ! And I also bought my plane ticket! I'm flying out the 29th, scheduled for the 29th, I have *never* done anything this radical before in my whole life. About spending the money, here was my reasoning: I have probably spent a hundred thousand dollars already on failed diets, new clothes, spanx, miracle suits, Jenny Craig, Nutrisystem, lowcarb supplements, miracle cures and pills such as carulluma, that white bean extract thing that's supposed to block carbs, alternative health practitioners, exercise programs I buy and don't use, depression medication, acupunture, hypnosis, and that does not even include the health problems I don't have yet but will that will need medication and attention such as diabetes and heart disease, an enlarged heart and whatever else goes wrong with fat people. Not to mention, I had a problem buying the flight today. I am so self-conscious about traveling and I don't want to be. I want to fit on airplane seats so I can travel, fit into normal sized pants so I can walk into any store -- I want to be free. My limitations are costing me so much more than the 8750 this thing is costing it's a no brainer. About going to mexico -- I'm self pay and its much much cheaper. I already contacted the bariatric center in my town and they say they will do aftercare. I have not read a single bad thing about Dr Aceves since doing all my research and I finally thought --, well, I have a passport....and so I got a first class airline ticket for the extra room and comfort since I was saving 12,000 dollars on the surgery bill I was quoted in my home state. I'm going alone. Im not telling anyone except a sibling. I am so embarassed I let myself get to this point. But now I see a way out! Yay!

I'm sorry to hear this, especially since I just decided to go with Dr. Aceves for his deal of 8750 in Mexicali. I know the issue with gas is malabsorption. Maybe you could try take digestive enzymes or Probiotics -- build the good bacteria and help the food pass through your system. But this brings me to a question I can ask you -- would this be the kind of thing you could talk to Dr. Aceves about -- in other words, is he available by phone to ask questions like that?

Hey Beth, we're at about the same starting point. I'm 41, 5'10" and 285.

That's what Im saying here. The charcoal underwear would be a dealbreaker for me. And I know there are some similarities in the effects of sleeve vs bypass; such as dumping in some people.

So we're good then? It's not a reported problem and should not be a problem?