Fight, fight, fight and fight

[SeattleLady 277]

Back story, sleeved in 2014. Everything went fine and lost 70 pounds. Starting having heartburn not bad. By year 5 severe GERD, gastritis, and medium hernia

Daily pain w/o meds. Insurance will not help. I have hope. However nothing is done until it is done. I understand clearly the medical community primarily does not view obesity as a disease. They are wrong.

It's sad seeing how I pay for my health insurance to keep me well.

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[GreenTealael 25,430]

30 minutes ago, SeattleLady said:

Back story, sleeved in 2014. Everything went fine and lost 70 pounds. Starting having heartburn not bad. By year 5 severe GERD, gastritis, and medium hernia

Daily pain w/o meds. Insurance will not help. I have hope. However nothing is done until it is done. I understand clearly the medical community primarily does not view obesity as a disease. They are wrong.

It's sad seeing how I pay for my health insurance to keep me well.

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Go back to your surgeon and ask them to test THOROUGHLY then submit it under revision for DOCUMENTED GERD (medically necessary)

Good Luck 💜

[SeattleLady 277]

Go back to your surgeon and ask them to test THOROUGHLY then submit it under revision for DOCUMENTED GERD (medically necessary)

Good Luck [emoji171]

Been there did that 🤣! The insurance company admitted that it is a needed procedure and not part of my coverage. I am working towards some type of resolution. Fight. Fight and fight. Currently, I am in bed and in pain.

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[Lynda486 784]

I really hope you can come to a resolution! Will be cheering you on!

[GradyCat 3,695]

Doesn't your medicine control the GERD?

[GreenTealael 25,430]

17 hours ago, SeattleLady said:

Been there did that 🤣! The insurance company admitted that it is a needed procedure and not part of my coverage. I am working towards some type of resolution. Fight. Fight and fight. Currently, I am in bed and in pain.

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Things to consider:

+Appeal decision over and over

+During the open enrollment period switch carriers

+Feverently lobby employer to switch insurers/ coverage plans

+Switch jobs or Move to a state thay will cover it

+Get an additional job/side hustle to afford Medical Tourism

+Medical loan or financing for the procedure

Good luck 💜

[SeattleLady 277]

Doesn't your medicine control the GERD?

No not all. My ph level is like 4x normal. It part due to the connection between my tummy and esophagus. Everything goes back up and stays up. All the money spent on test illustrate this is my only option.

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[SeattleLady 277]

Things to consider:
+Appeal decision over and over
+During the open enrollment period switch carriers
+Feverently lobby employer to switch insurers/ coverage plans
+Switch jobs or Move to a state thay will cover it
+Get an additional job/side hustle to afford medical tourism
+Medical loan or financing for the procedure
Good luck [emoji171]

Thanks for those ideas! The only thing I have not done? Move again. I am working on this daily by eating foods with a low ph.

I truly will continue to fight for obesity to be seen as a real diseases. We don't blame drug addicts for be addicts in the same way. I will get my surgery. I just want to help others do the same.

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[SeattleLady 277]

So, I am waiting on a decision. I am so tried of this crap. However, nobody going to fight for me but me/mine. I will know something by noon Friday. While, I sit in pain on this chair. I am believing for the best and ready to fight more as needed.

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[SeattleLady 277]

So, I am waiting on a decision. I am so tried of this crap. However, nobody going to fight for me but me/mine. I will know something by noon Friday. While, I sit in pain on this chair. I am believing for the best and ready to fight more as needed.
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Well, its past noon on Friday! Still waiting!

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[GingerSlim 128]

Keep fighting! I had the same GERD/hernia issues since I was sleeved 5 years ago. Just had revision on 7/23 and have not had one second of heartburn/reflux. Make sure your surgeon does endoscopy. Meeting with nutritionist & behavioral will speed the process along too. I saw both of them before even scheduling surgery and I didn’t need to go through any of the classes again. Best of luck!!! We are rooting for you!!!

[SeattleLady 277]

Keep fighting! I had the same GERD/hernia issues since I was sleeved 5 years ago. Just had revision on 7/23 and have not had one second of heartburn/reflux. Make sure your surgeon does endoscopy. Meeting with nutritionist & behavioral will speed the process along too. I saw both of them before even scheduling surgery and I didn’t need to go through any of the classes again. Best of luck!!! We are rooting for you!!!

Thank you very much! [emoji173][emoji41]

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[SeattleLady 277]

Go back to your surgeon and ask them to test THOROUGHLY then submit it under revision for DOCUMENTED GERD (medically necessary)
Good Luck [emoji171]

Yep, he did that! They said it not covered under my insurance. Currently, I am working with a patient advocate. I am fighting and trying not to just cry. I am in pain now. This sucks.

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[GreenTealael 25,430]

All else fails save up for Mexico...

Good Luck and get well soon 💜

[Stella S 612]

Keep the appeals and bury them in covered specialists. Drop money into a pretax health saving account if you think about out of pocket. Canada May be an option too.