Insurance recommendations...

[tarahuff82 7]

Hello all. It’s been a very long time since I’ve posted in here. I had sleeve in 4/2014. Was doing good, lost 80 lbs (definitely not as much as I needed to or hoped for) and as of 3 years ago I’ve developed server GERD and bad stomach pains. I’ve also had Achilles’ tendon repair surgery and a muscle tear surgery on my left elbow so my mobility has been very very limited. Achilles’ tendon surgery recovery time is exactly 1 year. And I had both done so to say the least, I’ve been home...not being able to do exercises at all, except resistance bands which I do do. So, with my weight gain all 80 plus more regain I’m exactly 22 lbs heavier than I was the day of my VSG surgery. I recently had an UGI and EGD done 2 weeks ago which showed severe GERD, gastritis and I have bleeding in my stomach as well the bariatric doctor said. He wants to do a revision to bypass which I’m very happy about, no more GERD and hopefully to get some weight off also. Question is; I’ve already checked with my insurance company BCBS and they said I was certainly covered for a revision as long as I meet 2 of the 6 comorbities and I meet 3. I had them send me the info on getting the revision and I’ve read it throughly and it says in it that if my doctor suggests that I do the nutrition classes prior to surgery then I have to. I am going to express to my bariatric doctor that this pain is unbearable and can he please do it ASAP. How long did y’all have to wait for your revision from getting your testing/procedure results back? Did your bariatric doctor make you go through all the nutritional classes all over again? I’m really really hoping that he doesn’t make me do these classes because I’ve already met my annual deductible and this whole revision bypass surgery will be fully covered 100% and I will have zero money to pay. Please tell me there’s hope. My next appointment with him is on October 29th so I’m praying he will give me some excellent news. I’m going to stress to him about my insurance as well. TIA for any feedback

[Orchids&Dragons 9,047]

My approval from Cigna was less than 10 days after my upper GI, showing severe GERD. I had the surgery within a few weeks after that.

I hope yours goes as quickly and that you feel much better.

Edited October 2, 2019 by Orchids&Dragons

[tarahuff82 7]

Thank you so much. I am just hoping that I won’t have to go through all the nutritional counseling/classes again and the psychiatrist eval. You’re giving me hope ☺️

[Orchids&Dragons 9,047]

47 minutes ago, tarahuff82 said:

Thank you so much. I am just hoping that I won’t have to go through all the nutritional counseling/classes again and the psychiatrist eval. You’re giving me hope ☺️

I didn't have to because mine wasn't considered a WLS, it was to fix the GERD. If yours gets presented that way, you may not have to do the WLS requirements. I hope it works out for you.

[GreenTealael 25,339]

GERD sucks.

I didn't have to wait long for mine either because it was for GERD not regain.

If diet issues were also behind regain the classes may help reinforce new/ better habits so it may be worth if you had to complete them.

Good Luck 💚

[tarahuff82 7]

Thank you!