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

Recommended Posts

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

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

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

Share this post


Link to post
Share on other sites

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

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

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

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

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

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

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

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

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

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

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

oh and anyone interested in staying in touch, please pm me so I can share my email :)

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

    • rlcpd

      Two months out from hiatal hernia repair.  Surgeon said to expect a lot more flatulence...something about the 'air' no longer being able to 'burp' out so comes out the other end.  That is my experience but have no understanding of why that swallowed air cannot be 'burped'. ???
      · 1 reply
      1. BlondePatriotInCDA

        As I understand it since your stomach is smaller and not completely resting against your diaphragm anymore you no longer have the ability to "push" burps out as well. Plus, since its smaller and we don't digest slower the trapped air moves a lot quicker out of the stomach so its no longer available to burp out. Hence the other option for removal.

    • Lizette1122

      Anyone had the TORe procedure? How did it go? How much weight did you loose? 
      · 0 replies
      1. This update has no replies.
    • LadyVeteran1

      Sleeve surgery is on April 14th.  I am counting the days!!  Can't wait!
      · 3 replies
      1. Brookie2shoes

        Me too girl!! Are you in the full liquid diet right now? It’s sooooo hard!

      2. LadyVeteran1

        Not yet. I was told I only have to do 24 hours of a liquid diet. But I have my pre-op tomorrow so I’m going to confirm if I need to do longer.

      3. buildabetteranna

        Your so close now! It's gonna be great :) Wishing you a speedy recovery and looking forward to seeing how it goes!

    • buildabetteranna

      Down 33 lbs and slightly stalled, but I'm gonna reevaluate and push through. I started back to work last week after 2 years of being disabled due to mental health as well as my weight. It's a great job and I'm just so happy to have this opportunity at a second chance at life. Hope everyone is having their best journey ❤️ Together, we got this!
      · 2 replies
      1. DaisyChainOz

        Great work Anna! Keep it up 😁

      2. buildabetteranna

        Thank you ❤️

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
  • 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

    ×