traycrow83 18 Posted March 17, 2013 I am suppose to get my sleeve 3/27 but just got a letter from the doctor that has me confused.saying the authorization from my insurance is based on medical necessity and not a guarantee of payment. I am confused and don't know what that means... Sounds to me like you dont have anything else wrong with you besides a higher BMI. No high blood pressure or diabetes. So your insurance wants it to be based on a need for the surgery. Basically they are not gonna cover the operation unless you have another problem do to being over weight. Share this post Link to post Share on other sites
beby241977 12 Posted March 17, 2013 I hope so, I am calling monday to find out. I hope they cover it. My mother already bought ticket to come and help me for 3 weeks and help me with my daughter Share this post Link to post Share on other sites
beby241977 12 Posted March 17, 2013 oh and keep in touch with me, if Id love to talk to someone that is being sleeved the same day I am planning on doing youtube videos to keep a video log 1 Moka reacted to this Share this post Link to post Share on other sites
beby241977 12 Posted March 17, 2013 Sounds to me like you dont have anything else wrong with you besides a higher BMI. No high blood pressure or diabetes. So your insurance wants it to be based on a need for the surgery. Basically they are not gonna cover the operation unless you have another problem do to being over weight. Yeah I have only now started having issues with high blood pressure. Basically everyone in my family is diabetic, high blood pressure and heart issues. I have had issues with weight all my life nothing new but now that I am getting older (35) its just getting even worst. Share this post Link to post Share on other sites
bostonhok 16 Posted March 17, 2013 Bostonhook & Angelaet Thank you so much for your kind words. I am still shaking with it all. His AA friends have been round but he's begging for a drink and lying and hiding drink. My poor mum. She's hiding all the car keys and watching him like a hawk. I'm keeping away for the sake of my daughter. But fingers crossed he gets some straight thinking from AA tonight. I guess I feel kinda selfish to be going for my op while all this is going on. But I've waited so long for this appointment I want to be done and on the other side. I wish someone could wave a magic wand and make it all ok. Do what you need to do for yourself. I too have experienced this with my sister who is in rehab as we speak for alcohol and drugs. Don't feel selfish.... Share this post Link to post Share on other sites
traycrow83 18 Posted March 17, 2013 Yeah I have only now started having issues with high blood pressure. Basically everyone in my family is diabetic' date=' high blood pressure and heart issues. I have had issues with weight all my life nothing new but now that I am getting older (35) its just getting even worst.[/quote'] They really shouldnt deny you if you are having blood pressure issues. I was just sleeved on thursday and I had a hogh BMI and also high cholesterol and I was approved 100 percent. I know all insurance companies are different but you obviously have fam history also. Share this post Link to post Share on other sites
Lain01 173 Posted March 17, 2013 I have been experincing alot of nausea. I was sleeved on 3/14. I know its only day three but does this get better everyday? Im not in alot of pain just having a hard time keeping any liquids/meds down. Help please Share this post Link to post Share on other sites
Lain01 173 Posted March 17, 2013 Tracy I am the same. Sleeved on 3/14. Keep getting dry heaves. I am having a hard time drinking anything. Share this post Link to post Share on other sites
beby241977 12 Posted March 17, 2013 They really shouldnt deny you if you are having blood pressure issues. I was just sleeved on thursday and I had a hogh BMI and also high cholesterol and I was approved 100 percent. I know all insurance companies are different but you obviously have fam history also. Yeah, I don't know because I honestly didnt even know about the high blood pressure until going through these appts. On my first visit I had high blood pressure and they said oh, it may be due to it being your first appt. I just let it go. Last week I went to my obgyn and they said you have high blood pressure...and I was I guess I do now...now it seems like its consistently Share this post Link to post Share on other sites
beby241977 12 Posted March 17, 2013 and now that I think about it, that may be why I sometimes feel like crap. Share this post Link to post Share on other sites
traycrow83 18 Posted March 17, 2013 Tracy I am the same. Sleeved on 3/14. Keep getting dry heaves. I am having a hard time drinking anything. Lain, I have found I was drinking my liquids too fast. I wpuld srink them and get bad pressure and then vomit. I am now taking small sips every fifteen minutes and havent vomited since. Still having acid reflux tho. Taking tums seems to help some. Good luck. Try taking small sips and space them out to 15 minute intervals Share this post Link to post Share on other sites
caglefan69 37 Posted March 17, 2013 Sounds to me like you dont have anything else wrong with you besides a higher BMI. No high blood pressure or diabetes. So your insurance wants it to be based on a need for the surgery. Basically they are not gonna cover the operation unless you have another problem do to being over weight. I don't have any comorbidities. No high blood pressure, nothing. I do have a BMI of over 40. I 5'5.5" and weighed 270.5 when I started this process in July. My insurance has strict guidelines and extensive pre-op diet and health testing. I have blue shield of California. They approved mine. Basically there were 2 cases which would qualify one for surgery: a BMI of over 40 OR a BMI of under 40 with 2 qualifying comorbidities. So to say her insurance want pay without comorbidities may not be true. Especially of its already been approved. It sounds more like an assurance of payment should the insurance back out (rare). Share this post Link to post Share on other sites
caglefan69 37 Posted March 17, 2013 oh and keep in touch with me' date=' if Id love to talk to someone that is being sleeved the same day I am planning on doing youtube videos to keep a video log[/quote'] Awesome. I would love to stay in touch! Stay positive, we're almost there. Share this post Link to post Share on other sites
beby241977 12 Posted March 17, 2013 Thank you everyone for the post. I will keep you updated when I call on Monday. I have not been in a good mood today when I read that letter Share this post Link to post Share on other sites
beby241977 12 Posted March 17, 2013 oh and anyone interested in staying in touch, please pm me so I can share my email 1 Moka reacted to this Share this post Link to post Share on other sites