Wednesday, October 22, 2008

Can I get some cheese with this whine....

Feeling frustrated last couple of days. I am mad at myself that I didn't just have RNY 5 years ago and yet I am thankful that I have found the new WLS's I didn't know about like DS and VSG. I really want to have the sleeve but after going through all the paperwork, seminars, testing and money, I just now start really looking at my insurance policy. (Much thaanks to all the OH folks for all the advice, especially about researching before you choose a surgeon or surgery...wish I had known that before) My insurance policy lists all the surgeries...RNY, DS, VSG, LAP, BPD, GB..then it lists all six requirements of eligibility and gives CPT codes for surgery...flip to the next page...lap is not covered for BMI's over 50, oh and we don't cover sleeve gastrectomy AT ALL annnd, no 2 part surgery requests will be approved. Hmmmm sounds like RNY is all that is left!! Why should the insurance company get to decide??? If my surgeon, myself , PCP and enocrine dr. all think VSG is a good way for me to go then that is how it should be. So I blew the smoking thing out of the water...Bought a pack, smoked them....bought another pack. I just don't understand. My surgeon's office is submitting for VSG anyway, we shall see but my hopes are not very high!! I need to win the lottery so I can self pay and decide what is best for me not the insurance company. My advice to anyone looking into WLS for the first time...Spend months researching WLS options, lurk and ask questions on all forums on OH (, know your policy inside and out, choose a surgery, choose a surgeon and then JUMP!! Then again, maybe my subconscious knew I would back out if I didn't get my way so I invested all the time and money so I would do something, whether I wanted RNY or not. Nahhh, that's not it!

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