Jump to content
×
Are you looking for the BariatricPal Store? Go now!

One Year's Work to get Surgery Approved



Recommended Posts

During 2010, I have worked for three companies and had three insurance plans. This had made my journey to have gastric sleeve surgery interesting, to say the least. I started pursuing having bariatric surgery January 1 of 2010. My employer had included it in the insurance plan for the first time. I started looking for a center of excellence for the surgery in Dallas. Nine days later my employer ("Company A") sold my division of the business to "Company B". Thank goodness Company B had bariatric surgery in their plan, so I decided on a surgeon - Dr. Nick Nicholson after doing research and attending one of his seminars. I started attending a monthly meetings with a dietician. Company B insurance didn't cover the sleeve, so my second choice was gastric banding. Then, eight weeks after the sale of the business, "Company B" announced a layoff - which included me. I had until May 31st, then I would be unemployed. Company B's insurance required six months of meetings with the dietician, plus other requirements. There was no way to meet the requirements for the surgery before I was laid off, so I planned on using COBRA until after my recovery. Good news - I found a job with another division of Company A, and started June 2nd - I had one day off - the Memorial Day Monday holiday. No COBRA needed. I informed Dr. Nick's insurance lady and she coordinated me working to meet the requirements with Company A. Still no sleeve available, so I continued planning on the band. I had two sleep studies and continued with the dietician meeetings. Twelve weeks after I started back with Company A, they sold that division to "Company C", who was their partner in the joint venture. (I knew this was coming before I went back to Company A - I wasn't surprised.) I had to change insurance plans from Company A's plan to Company C's plan. I tried to get the surgery approved before the changes went through, but couldn't get it done. Thankfully, all the dietician meetings counted, as did the sleep studies. I had a psychiatric evaluation done in December. Also in December, Company C's insurance decided to include the sleeve as one of their approved procedures. The timing was perfect for me. So, the very patient isurance lady at Dr. Nick's applied for my approval for the sleeve. I received approval on December 29, 2010 - my 54th birthday. I have my meeting with Dr. Nick on January 19th, and hope to schedule surgery for late in February. I started this journey weighing 253 pounds. I have lost about 13 pounds during 2010. My goal is to lose an additional 100 - 120 pounds as a result of the surgery, diet and exercise.

Share this post


Link to post
Share on other sites

My,my……what a tumultuous year and a true example of alls well that ends well. You'll end up with a sleeve (which my bias thinks is better than a band) and you got all of this accomplished with so much going on in your life.

Good luck to you!

Share this post


Link to post
Share on other sites

Wow, what a story. I'm sure you will do well all you have gone through with thus far. Patience and presistence sure pays off. May you soon have your surgery date.

Theresa

During 2010, I have worked for three companies and had three insurance plans. This had made my journey to have gastric sleeve surgery interesting, to say the least. I started pursuing having bariatric surgery January 1 of 2010. My employer had included it in the insurance plan for the first time. I started looking for a center of excellence for the surgery in Dallas. Nine days later my employer ("Company A") sold my division of the business to "Company B". Thank goodness Company B had bariatric surgery in their plan, so I decided on a surgeon - Dr. Nick Nicholson after doing research and attending one of his seminars. I started attending a monthly meetings with a dietician. Company B insurance didn't cover the sleeve, so my second choice was gastric banding. Then, eight weeks after the sale of the business, "Company B" announced a layoff - which included me. I had until May 31st, then I would be unemployed. Company B's insurance required six months of meetings with the dietician, plus other requirements. There was no way to meet the requirements for the surgery before I was laid off, so I planned on using COBRA until after my recovery. Good news - I found a job with another division of Company A, and started June 2nd - I had one day off - the Memorial Day Monday holiday. No COBRA needed. I informed Dr. Nick's insurance lady and she coordinated me working to meet the requirements with Company A. Still no sleeve available, so I continued planning on the band. I had two sleep studies and continued with the dietician meeetings. Twelve weeks after I started back with Company A, they sold that division to "Company C", who was their partner in the joint venture. (I knew this was coming before I went back to Company A - I wasn't surprised.) I had to change insurance plans from Company A's plan to Company C's plan. I tried to get the surgery approved before the changes went through, but couldn't get it done. Thankfully, all the dietician meetings counted, as did the sleep studies. I had a psychiatric evaluation done in December. Also in December, Company C's insurance decided to include the sleeve as one of their approved procedures. The timing was perfect for me. So, the very patient isurance lady at Dr. Nick's applied for my approval for the sleeve. I received approval on December 29, 2010 - my 54th birthday. I have my meeting with Dr. Nick on January 19th, and hope to schedule surgery for late in February. I started this journey weighing 253 pounds. I have lost about 13 pounds during 2010. My goal is to lose an additional 100 - 120 pounds as a result of the surgery, diet and exercise.

Share this post


Link to post
Share on other sites

Wow!!! That's some story - however it sure seemed to work out in your favor!

All the best in your upcoming days. You will certainly LOVE YOUR SLEEVE!! Be glad it worked out in the end, for I had a band too. Note I said HAD. ;)

You also have the absolute right mindset, you will surely lose with the sleeve... and diet (I call it healthy eating) and exercise. :)

Share this post


Link to post
Share on other sites

Wow, that journey tired me out! I have to say you are persistant where many may have threw their hands in the air and gave up. Congrats, I know you will succeed!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×