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deletedeletedelete

Gastric Sleeve Patients
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Everything posted by deletedeletedelete

  1. deletedeletedelete

    Starting a VSG Journey Youtube channel!

    Check out my first video, I'm really looking forward to documenting this process
  2. So I'm new to this journey, just getting informed and seeing if I will even qualify. I have a few insurance issues that I'm worried about. I'll attach my insurance company's policy. Basically in order to have the surgery covered, I need to have been severely obese for the past 2 years (40+ BMI or 35+ BMI with comorbidity) I think I've fluctuated a lot between 35 and 40 in the past two years. As of right now, I'm right on the line of 40 (because I'm 260 lbs and 5.8 and at my doctor's office they even tacked on half an inch!) Anyway, I brought up surgery to my doctor thinking she would want to give me lots of other options but she was actually very supportive because she had sleeve surgery last year! I told her that I've been struggling with obesity my whole life, and it's definitely affecting my quality of life (I'm only 27 but feel as old as my mother some days). So I also told her that I suspect I have sleep apnea but I just never thought it was that big of a deal so never had it diagnosed (even though I've had symptoms for 10 years). I have a sleep consultation on May 16th, but even if I am diagnosed, will that count for a comorbidity? I haven't had the official diagnosis for at least 2 years and I haven't been 40 BMI for at least 2 years. I'm worried that will get my insurance claim denied... I feel like this is an obviously dumb question to post but I'm just heartbroken thinking I won't qualify because of timing...anyone have experience similar to this? bariatric-surgery-in-adults.pdf
  3. deletedeletedelete

    Sleep Apnea (timing of diagnosis)

    I'm looking for a second set of eyes to help me decipher my insurance policy/share if they've had similar experiences with their insurance hurdles. Before anyone asks, yes I have called my insurance company to clarify but the woman on the phone seemed a little unsure about the details of timing and that's where I think I might get denied! I'll link my insurance co's policy here: POLICY My history: In the past 2 years I've had a BMI between 35 and 40 (however I have been pregnant in that time period). I've had sleep apnea symptoms for probably 10 years but didn't think they were a big deal but now that I'm trying to get approved for VSG I'm going to be tested for sleep apnea. Questions: In my insurance coverage policy it says "presence of severe obesity (for at least 2 years before surgery)" I know my BMI has been between 35 and 40 but I have been pregnant in that time too, will that count against me since some of the excess weight was from the baby? "Severe obesity defined as a body mass index (BMI) ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 with at least one clinically significant obesity-related comorbidity." I know I've had the BMI for the past 2 years but I haven't had the diagnosed comorbidity for the two years since I'm yet to be diagnosed. Will the timing matter on that? Will the insurance company need there to have been a comorbidity present in the last 2 years to approve me or will just being diagnosed before sending in for approval be ok?

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