giant setback prior to GB

velbing

I started my process in January and was so excited to be judged "qualified" for gastric bypass. Shortly after that however, things fell apart. My insurance covers the surgery itself for a BMI over 40 and I'm there. Only one provider is authorized however.

The hard part I've found is that the only provider they cover requires 6 months in their comprehensive weight management program. THIS is NOT covered by my insurance. My insurance does not require the 6 month waiting period...the visits with the nutritionist, and the behavioral counseling, nor do they cover it.

After making so many changes to my diet, to my behaviors getting myself ready for this process...I'm now at a stand still. Neither the insurance company nor the provider will back off on their requirements.

I'm so frustrated and disheartened.

cheekitty

My program had a flat fee. Visits to the nutritionist, psychologist, endocrinologist and surgeon were billed as office visits, so my insurance paid for that, but I still had to pay almost $500 up front to even join the program. (I was supposed to have my surgery 12/9 of last year, but then we discovered my insurance didn't cover the surgery. I so understand your dismay and frustration)

My best advice would be to look at your options. This is your health, thusly it's important. Talk to your provider, see what costs you're looking at for their 6 month program, discuss any payment plans or financing options that may be available.

Don't give up. I cannot iterate that enough. I began my program in November of 2012. I had surgery in March of 2015. It was a long, excruciating road. But it's 100% been worth it.

rpyle111

If your surgery is a Bariatric Center of Excellence, it may well have requirements that are above and beyond some of the insurances that its patients use. I believe that this is a good thing (not that you have to pay for it, but the pre-op time). I used my pre-op time to really hit the plan hard, getting into physical shape, losing a lot of weight and getting my mind ready by adopting the habits and behaviors I would need post op.

Obviously, money matters, but following your program's pre-op plan is likely to end up with a better result.

Good luck to you.

Rob

lmryoung

I started out at 3 different programs (insurance caved in me the first two times) and I paid that $500 program fee and went through the nutrition and psych stuff every time. It's part of any program that is a center for excellence. I just embraced it every time as a chance to learn as much as possible before my surgery in the hopes that would lead to greater success after. Four years of going through bariatric classes, consultations, testing, etc., and my surgery is in 5 days. (Finally!) Believe me, 6 months will fly by.

cabennett99

I know that once I made my mind up, I was frustrated at having to wait several months for the supervised weight loss program, specialist clearances, etc. But in hindsight, I can honestly say that I was very prepared for the experience, and I'm glad they made me take that time.

JamesAztec

If you can somehow afford to pay for the plan, then DO it. You may need to borrow from CCs, friends, family, etc but if you feel bariatric surgery is your best option for long term health than it will be worth it. You will make up the money spent in food savings and medical bills (prescriptions, etc) in just a few months after surgery. Think of it as an investment in your health, your family, and long term quality of life.