insurance vs. co-morbidity

[paristupperware 2]

OK, so I have UHC as my insurance right now. But my current plan does not cover the surgery. I am switching to a plan that does cover it, but that will not be effective until Jan 1. In the mean time, I have been going to regular NUT visits (I have been working on this for over a year now, do to insurance changes). Over the last 3 months I have seen some weight gain, and my GP finally referred me to a vascular center. This new Dr. gave me the diagnosis of lymphedema that has gotten inflamed because of outside issues. These outside issues mostly revolve around stress (of a few different types and happened at the same time). I was told by my NUT that for most insurances I need to be at or below my starting weight in order to have surgery. Right now, because of the lymphedema, I am above my starting weight. since lymphedema does not have a "cure" and there is treatment, but it takes time for the treatment to be effective. I was also told that WLS will help with the lymphedema

Does anyone have any advise on how I should proceed in the process? I was planning on having the surgery in Feb/Mar with the new ins.... is that now going to be delayed?

[2goldengirl 2,076]

Impossible to say unless it's been actually presented to the Plan for approval, BUT, weight gain from lymphedema is hardly the same thing as weight gain from overeating. Lymphedema is not a contributor to obesity, though obesity may exacerbate lymphedema.

Your NUT is not the expert in insurance approvals, your surgeon's insurance coordinator is. That is the person to speak to with your question. You don't say who your new insurance will be.

[BLERDgirl 6,417]

You could start looking at programs and informational seminars. There may be a rep there that can answer insurance related questions like this.

[Pinkgirl1234 761]

Inflammation is a big deal as a cancer survivor it is a comorbidy.Are you being treated for it with a physical therapist?It harnesses Fluid and Water retention.Obesity makes it worse.

[paristupperware 2]

@@Pinkgirl1234 my lymphedema is not cancer related (it is congenital, I have had swollen legs for as long as I can remember and the drs just kept me on diuretics). This is the worst the swelling has ever been, I just got sent to the right dr this time. This dr did not recommend physical therapy, he is suggesting compression therapy 3x a week to start out with. I just met this dr last week and I have yet to hear from the clinic to schedule the therapy sessions.

[Nora82 11]

I would definitely get a note from your doctor who is treating your lymphedema to send in with your preauthorization that states that the recent weight gain was due to this issue. If they mark the date that you started having issues with it and coincides with the time you started gaining weight it will definitely help.