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Where do I even start? And what's the fastest route (I have restricted time)



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Hi all. I've finally committed to getting Sleeved. I have a few questions because I'm a little uninformed on 1) the process to get started 2) the process/options with my insurance.

The basic info: 30 years old, live in Los Angeles. Lifelong overweight and dieter, currently about 300 and 5' 3". I've tried medically supervised weight loss before (Kaiser), but I don't have ANY comorbidities. I might have very mild sleep apnea, but will obviously have to get tested for that.

Insurance: right now I have Medi-Cal with LA Healthcare.

1) What is the process to get started? - I've never been to my current PCP. Is it possible to get a referral from her on the first visit? lol.

Should I have Kaiser send her all of my medical history before I go? According to her reviews, it takes forever to get appointments with her, so I would really like to knock out as much as possible in as few visits as possible.

2) How does the referral work? - Pardon my extreme ignorance here. I've had Kaiser for my whole life, so I've never had to deal with referrals like this.

Whenever I do get a referral, is it a referral that allows me to go directly to a bariatric surgeon? I already have a surgeon in mind, so it would be nice to just get the sign off from a PCP and go straight to him.

3) What if my insurance changes over the next few months? - The slightly more complicated part - I'm unemployed right now.

I was laid off from my job in November and that's why I'm currently on Medi-Cal. I'm hoping to start a new job in the next few months, HOPEFULLY. And with a new job will come new insurance. Has anyone ever had experience with switching insurance in the middle of bariatric process? I actually think getting the surgery approved through Medi-Cal/Medicare is a lot easier and faster than it is with private insurance companies, so I'd like to do it under my current insurance, but have no idea if it will be fast enough.

4) What about weightloss centers instead of Primary Care Physicians? -

I saw someone elsewhere mention that she took a class at a weight loss center and her insurance approved surgery via their recommendation/request. She was covered by Medicare, didn't pay much out of pocket, and was scheduled within 2 or 3 months. Is this a better option in regard to timeliness? I'm in LA, the city of vanity, so there are a billion different kinds of weight loss centers and I'm not sure which would be the type to recommend me for surgery (i.e. a lot of them want to keep you on the schedule to pay a bunch of money for B12 shots). Any suggestions here?

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My doc wrote two or three good books on the subject. He is listed in my profile. Or get some of the books mentioned in the earliest of posts for pre-op sleeve patients.

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By the way, don't go for fast. If you are on a time crunch then it would be best to do it after the date than to mess yourself up permanently by being so much in a hurry you harm yourself.

Remember the difference between the old bull and the young one? Be the old bull.

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Insurance can answer what surgeons are approved providers, and required referrals. Yes get your records sent to both the PCP and the bariatric surgeon's team. If you know which surgeon is in-network request it, be him on the referral.

Some (most) surgeons require you go through their program and it varies by surgeon - some are weeks and many are 6 months. You see nutritionist, psych eval, EKG/stress test, bloodwork, ultrasound of stomach and legs, EGD (scope of esophagus and stomach, etc. Some insurance requires this as well.

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Go see your PCP. Tell that person your intentions ahead of time & ask what paperwork or other information you need. That person should be able to get you started. Good luck!

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Thanks to you both! The whole process with my insurance is so convoluted and confusing, but I think I've got it mostly figured out. I have an appointment scheduled with my PCP and will be sending all of my previous medical history to him before the appt. Other than that, we'll see what happens!

Thanks again.

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