BinIA

Yep - I think it depends on the structure that the employer has set up with the insurance company. This employer is unique I think in how they pay their bills from the insurance company. It is up to the employer not the insurance company. They won't necessarily change their policy - they will just allow an exception on a case by case basis of whether the employer wants to cover it.

1) I see a lot of people talk about not having an appetite for foods they previously enjoyed or not being able to swallow certain foods. Why is this? My naive thought process is that your stomach had a procedure but your taste buds didn't and why would something that happened to the stomach impact your ability to swallow certain foods? 2) I see people talk about not losing much weight or immediately having hunger again. Why is this? Is there a percentage of people that a smaller stomach doesn't work for? How can you not lose weight with a significantly smaller stomach {aside from poor food or liquid choices}. I know we all have different metabolism and our bodies process foods differently - I don't necessarily believe in the whole "calories in, calories out" thing but ... seriously, how can your body not lose if your stomach is like 80% smaller and you follow the food/liquid rules? I don't ask to sound rude to those that struggle - I ask because I don't want to be in that percentage. What is the percentage of people this just doesn't work for? 3) Has anyone had the inverted gastric sleeve surgery? I see there are a couple surgeons, that i've come across, that add an extra step to the surgery {of course they each call it something different and put their name on it as being a pioneer ha}. One of course being that of Dr. David Kim in TX. After stapling the stomach line, they invert that line and then sew up. Adding a double layer protection from leaks, and making stretching more difficult to do. THIS sounds like a great addition to the surgery. Anything that reduces further any complications post surgery and makes it more difficult to 'beat' the size sounds good. Thoughts, opinions on this?

My insurance is with BCBS out of OK [i'm in Iowa} and the employer has an exclusion for ANY type of weight loss program/surgery. My husband met with HR about this and they told him that they have made exceptions for other employees not specifically for weight loss surgery but for other excluded items. So the HR guy took the handout information I gave my husband about the cost benefits of covering WL programs/surgery to the proper channels and it looks like they may go ahead and include my WL surgery. Just a thought for those that might in similar situation.

Thanks all! I am feeling more positive and husband said we will make this happen one way or another.

And ... my husband who is an officer at his company {though he just started a few months ago} spoke to HR today about the exclusion and gave him documentation that I found. The HR guy told my husband that there is an appeal process and that other excluded items have been approved to be covered in the past so he is going to start the appeal process for me to have this surgery. I don't know how long that will take as it is an internal thing - BCBS of OK clearly has coverage available for bariatric surgery so this just comes down to the employer. http://www.bariatric-surgery-source.com/support-files/bariatric-surgery-insurance.pdf

Thanks all. I'm researching the texas options. I do really like the sound of Dr. Kim and his version of the gastric sleeve. Feeling a little more hopeful.

I just would rather have access to my surgeon if some sort of complication comes up down the road. Otherwise, who do I go to? I mean, my primary doc is great but ... I'm in Iowa. Texas isn't a terrible distance. Do you have any recommendations or referrals for TX? After I got done with my pity party ...I called a couple more places here in Iowa. The third place I called is 17K which includes Blis, 2 night hospital stay, and post surgery office visits. The pre-surgery visits {3 of them} run from $180-$220 with a 30% cash discount. Which is nicer than the first place which did not include post surgery visits and their pre-surgery office visits were 150-550 with NO cash discount. I really LOVE how these places websites say that people 100 pounds or more overweight have a 98% chance of losing that weight without surgery. Making it medically necessary. But then on the phone tell me they offer no health credit or cash discounts because this is 'elective - not necessary surgery' ... maybe that lady was just a jerk.

I've spent months reading everything I can about VSG. I researched doctors. Finally made the call. Looked at my husband's insurance and after he changed jobs this new employer does not allow BCBS to cover any weight loss program/surgery or complications. So the surgeon's office doesn't seem to be that interested in working with a cash patient. It's 20K up front in two different checks - one to hospital and one to dr office. Does not include appointments with the surgeon which run $150-$550 per appointment depending on the 'level of care' they provided. I don't want to go out of state or country. I just assumed we had good insurance. I'm feeling really devastated and defeated. I had worked myself up to this ... I talked with my husband about it. I did so much research but didn't even think that our insurance wouldn't cover it. So stupid of me. I guess back to nutrisystem ?