Jersrose43
Gastric Sleeve Patients-
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Everything posted by Jersrose43
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Supplement insurance in case of complications?
Jersrose43 replied to mbuczkowski's topic in Insurance & Financing
Supplement means they cover copays and such. Not services that are rejected by others. Make sure you read the fine print -
Self pay: Insurance to protect against complications?
Jersrose43 replied to mbuczkowski's topic in Insurance & Financing
If you follow the rules of your coverage and get denied for lack of coverage for vsg you should be ok It's when you bypass the insurance completely and go cash pay that complications are also denied Make sense? -
I don't know how much longer I can do this... But no choice
Jersrose43 replied to kelbelle29's topic in Gastric Sleeve Surgery Forums
I don't think you were ready nor appropriately prepared for a lifestyle change This is a way of life not a diet. Not temporary. I hope the new clinician helps you. Find a nutritionist who is experienced with bariatric patients and maybe they can provide the eating support you need. And finally join an eating addiction group. I never considered myself a candidate but guess what. I sure as heck am. I see it and I want to eat it!! -
So not Cigna fault your doc didn't submit the September weigh in.
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Guess you answered the question for yourself. All plans are different Especially if exchange vs employer and differs from employer to employer even if it's the same company
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If you have not finished the 6 months yet - are you at 5? Otherwise why are they bothering ? Missing a lot of details here
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They have to give the insurance something and once approved can change it easily
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Your united policy is specific to the employer so because you don't work there United won't be able to tell you anything at all. United does cover it if the employer chooses the rider. 85% of united business is self insured therefore each employer can choose what they pay for and what they do not There are legislative requirement but weight Loss surgery is not federally required. There are 13 states that mandate you must cover it. You might want to google it.
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And even if they do reimburse you. It would only be their normal reasonable payment. Which tends to be 30% of what a doctor and hospital actually charge. Wait. My charges were $42k for hospital. Insurance paid $4800 The surgeon was $20k and insurance paid $4200. Anesthesia was $3800 and they paid 100%
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Elevated Liver Enzymes
Jersrose43 replied to pinkbunies's topic in POST-Operation Weight Loss Surgery Q&A
Remember that the liver is the body filter. He is removing the medication because it may be too much for your smaller body. -
Elevated Liver Enzymes
Jersrose43 replied to pinkbunies's topic in POST-Operation Weight Loss Surgery Q&A
The elevations can have multiple causes. My dad has very high levels but he is alcoholic and his liver si finally showing signs of failure. Mine were high before being sleeved and combines with two other tests doc said I was becoming prediabetic. You also said you've been working out with a. Trainer. It could be you have damaged some muscles and you enzymes are high due to that. Here are some ideas http://www.medicinenet.com/script/main/mobileart.asp?articlekey=6274&page=3 -
Thinking of changing surgeons
Jersrose43 replied to gsusser's topic in PRE-Operation Weight Loss Surgery Q&A
So call insurance and find a new one. Have a first consult you lose nothing. Then before you make the final change-- call her and discuss how you feel. May be a one off thing. Maybe she had staff quit. Or someone higher up doesn't support the practice. If this is always the way it was run then perhaps you should go. -
Self Pay Questions for First Consult
Jersrose43 replied to BrightEyes529's topic in PRE-Operation Weight Loss Surgery Q&A
Be really specific what is included. Anesthesia, hospital, radiology, pathology, etc. Also what aftercare and for how long -
Reading between the lines but if your friends all had some form of WLS and they're running a support group and all had same surgeon as you. It seems like they've taken the perspective that you are blaming their doctor for your negative experience. They're probably thinking you knew there were potential for a challenge to this surgery. There are many who don't have as wonderful experience as others. It is unfortunate that you are having a rough road but perhaps you need to stop talking to them about the surgeon. It really isn't the surgeons fault this happened unless he did something negligent which you didn't say he did. But they feel you are saying it to them. Just stop discussing the surgeon and laying blame there. It is what it is and you're getting better. You don't need them to listen to you assign blame. You need them to support you. Which to me is more about getting you the right nutrition, the right sources to help you through this.
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Anyone know of aMedical Tourism insurance
Jersrose43 replied to Pejela's topic in Gastric Sleeve Surgery Forums
The point of medical tourism is to go and pay cash I think. So you may be challenged to find something that provides insurance -
I went to a wedding At 4 weeks out. That was a year ago. I lived to tell as you can see I had white wine - I would sip and when it got warm I got a new one. I drink at least two vodka tonics a week since 8 weeks out.
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Sundresses-CHEAP for after surgery/weight loss
Jersrose43 replied to theatrejo's topic in POST-Operation Weight Loss Surgery Q&A
I have found dresses at old navy for $10 -
All insurance offered by employers will have employer specific Benefit coverages. Not insurance company specific. So 20 people can have bcbs Florida and 20 different kinds of benefits if they work at 20 places or buy it direct.
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Hello did they forget about me!
Jersrose43 replied to ShareeB's topic in Tell Your Weight Loss Surgery Story
Hubby had a heart attack last week Admitted obviously. After 5 hours after being admitted he's still sitting in ER. I don't think they forgot they have others ahead of you. Their issues are running long. No consolation for your anxiety but they certainly didn't forget you -
And we have a winner! Couldn't agree more!
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Fatigued at 9 months out!
Jersrose43 replied to Janice1968's topic in General Weight Loss Surgery Discussions
Exhaustion is my middle name. No Vitamin deficiencies but nut was my b levels higher. So at 1 yr started shots once a week. Trying for one month to see if it makes a diff I take Centrum complete and a centrum for women every day. -
CMS federal guidelines are here. I skimmed did not see a pre surgery requirement period. http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=57&bc=AgAAgAAAAAAA&ncdver=3 Also if you have Medicare advantage they may add additional requirements like an EGD or other testing but have to be minimally the same
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Major break down
Jersrose43 replied to shelleylester's topic in POST-Operation Weight Loss Surgery Q&A
I think you need to get to your surgeon ASAP. That doesn't sound right. Oozing and pain this far out. Maybe even call him and gave service page him. Is it oz zing a color or smell? That would be a sign of infection. -
I know exactly how you feel and I hope I haven't come across to others as judge. But sometimes people do post that they return to their old habits. I ignore for the mostpart. What really bothered me last week was a person with 9!!!! Posts being judgment on someone 2 months out. No she had not had surgery. The Facebook groups are equally as bad and I block those idiots thankfully. I hope you continue to return and find the support you need. I am a year out and happy as so&&. And enjoying my birthday today with SEVERAL vodka tonics. Let the judgement begin
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You can call them and ask for a copy of the medical policy which can details the specific items you need The medical "packet" comes from the surgeon who will usually require more than an insurance company requires