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Ahh Hoping This Is Worth The Battle



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So I am new to the whole weight loss surgery. I first wanted the lap band but then attended a seminar and believe the Sleeve is so much better for me. Met with my normal doctor to discuss the surgery and right away he said he does not believe in it. I then had to search for a doctor and call and make sure that there had been referrals from him before. I found one and have my first appointment on Sept 4th to get referred to the center that will be helping me. My insurance requires an in network doctor to refer me for it to be covered. I think that is going to be my biggest challenge...insurance. I am also currently at a BMI of 39 and I am not sure if i have any co-morbidies. Sort of frustrating becuase i feel like I am always the one who falls right between the lines and I have fear i wont be approved. I am 21 and a single mom and started my journey back in June. I would love all the support I can get in this process and any tips along the way. I am ready to defeat this weight that has been with me since elementary school.

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Just keep at it..it will work out!!

This surgery has been the best thing I have ever done for myself.

Best of luck navigating through!!

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Did you PCP give you a reason why as to why he doesn't believe in it? His job as a physician is not to pass judgment on the procedure itself or whether or not he agrees but rather make a determination if this will positively impact your (his patient's) life.

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UTGal99, he did not. He began to say and then my mom said she had the Gastric Bypass done a long time ago becuase of our Family health. He said well I would need a diary of everything you eat the time weight and amount and I need blood work but I strongly believe this can be changed with good eating and working out. I brought in all the diets and workout plans I had been on since elementary school and he really had nothing to say. So I found a new doctor which I see in a month. I am preparing myself for a long battle.

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Kenzee,

Be persistent! That is the best advice I can give you about insurance. They may have hoops and leaps and whatever other stuff required for you to do pre-surgery. Follow it to a T, document every insurance person you talk to, and keep a list of requirements and your progress on them. Insurances are very picky about what they will and won't cover, so you probably want to call your insurance now and see if they will give you a list of requirements so you can start working on them.

Start now keeping a diary of what you eat and your weight every week. Bring it with you to the new doctor, along with your documented weight last visit with the doctor who did not want to refer you. Have your old doctor forward all of your records to your new doctor. This way, if your insurance requires a few months of dieting and supervised weight loss, you will hopefully be able to have a month of that down.

Gather the list of medical tests you will need done if you need comorbidities to get the surgery covered. Do you have sleep apnea? Do you have joint pain related to obesity? Do you have trouble being able to spend time with your child the way you want to? High blood pressure? List of all of the things you can think of and see if they qualify as comorbidities.

See if you can get a documented copy of your weight over the past 5 years from your old doctor. Some insurance companies want to see that you have been obese over a period of time.

These are just my suggestions, I'm sure there are more things you can do to be prepared, but that's what I can think of off the top of my head. I hope that things go well =)

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IZuri,

Thank you so much for this. I feel like you just gave me a boost of determination. I have Pacificare *** so I need a Doctor's referral to get approved. Does it matter, do you think, that there was a gap of time where I didnt really go to the Doctor during highschool but I have always had a high BMI in the "obesity" category. i just want everything to work out you know. Just like everyone else lol

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Met with my normal doctor to discuss the surgery and right away he said he does not believe in it.

OK that doctor is dumb. What does he think the surgery is? Santa Claus?

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Okay I'm so glad you are getting a new doc! It's concerning your doc doesn't seem to want what is best for you...

Anyways, once you see the new doc, hopefully they will recommend surgery and get the process rolling. As far as comorbidities-have you ever had problems with sleeping, blood sugars, infertility, blood pressure, arthritis? Like others have said, document document, document!

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MamaMelly,

Thank you! I know when I was there I couldnt believe it! I felt so discouraged after that then I went to the seminar and the ladies told me you need to change doctors. My family history is prone to diabetes, high blood pressure, high cholesteral. I had a blood test done but I dont believe i have any of these. I do feel pressure on my chest when i sleep and have no energy anymore. So i will bring that up. I am going to start documenting today of everything so i am prepared.

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IZuri,

Thank you so much for this. I feel like you just gave me a boost of determination. I have Pacificare *** so I need a Doctor's referral to get approved. Does it matter, do you think, that there was a gap of time where I didnt really go to the Doctor during highschool but I have always had a high BMI in the "obesity" category. i just want everything to work out you know. Just like everyone else lol

Glad I could help. Where there's a will, there's a way =)

I do not know what your insurance requires exactly, I just know that there are some people who have said on here that their insurance requires a rather lengthy list of their previous weights. My insurance did not seem to care at all about my previous weights. It's just better to have all your bases covered. If you have records from as far back as you can get them, that's what I would do. That way if/when you need them, you have them. If you have any questions or issues along the way, send me a message =)

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