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Topic : Pros and Cons of Gastric Bypass Surgery

Number of Replies: 84
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Created on : Tuesday, August 08, 2006, 02:17:36 pm
Author : DrPhilBoard1
Have you or a loved one had gastric bypass surgery? Share the pros and cons with others contemplating this procedure.

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September 18, 2008, 11:43 pm CDT

HELP FINDING RIGHT INSURANCE

I have no insurance and do not have enough money for this surgery. I am willing to buy private insurance for a while if it would eventually cover surgery, however, when you ask sellers of policy if policy covers, they either won't answer or say I would have to sign waiver and not be elegible or that it would be considered pre-existing condition. How do I find a specific policy information to get coverage for future help?? Anyone got any ideas?
 
September 18, 2008, 11:52 pm CDT

insurance issues

Quote From: layoungren

I have no insurance and do not have enough money for this surgery. I am willing to buy private insurance for a while if it would eventually cover surgery, however, when you ask sellers of policy if policy covers, they either won't answer or say I would have to sign waiver and not be elegible or that it would be considered pre-existing condition. How do I find a specific policy information to get coverage for future help?? Anyone got any ideas?

nevermind - after acually seeing what insurance would cost.... I can't afford that either...I am caregiver for mother with Alzheimers and father who can barely walk with a heart condition. I can not work, I take care of them all day 7 days a week. My daughter tries to help, she is full time college student and works, she just does not have time with studies and work.

If anyone has any idea's please let me know... I live in central IL and would plan this around my daughters college break or she has offered to take a semester off for me to get the surgery

 
November 30, 2008, 6:01 pm CST

insurance

i had to fight my insurance company to have the surgery done but they finally agreed wih my doctor. i was a diabetic now i dont have it anymore  good luck
 
January 6, 2009, 7:20 pm CST

June 30, 2008 my new life began

June 30, 2008 my new life began

After 5 years of researching and then pursuing gastric bypass my journey came to fruition. After 4 children; 2 marriages; my associate then my bachelors finally my masters in nursing; fighting to get a job where the insurance would pay for the procedure.... I decided I was going to have the surgery whether I had to pay for it, beg for the money (actually thought about posting on Craigs List or charity network), however it would happen. I believed no different. I took on advice from "The Secret", positive mental imagery....anything to keep me motivated. Then after a year of going this route and continuing forward with evaluations, anything I thought test wise would be needed for the surgery, it happened. A fluke really.

I had thought ok well if I am going to have to pay for the surgery then let me get a good paying job, in an area of nursing I can recover well in after the surgery. I had all but two tests done. Interesting how my insurance would pay for all the tests my PCP was ordering thinking it was related to my complications or diagnosis (ie wt induced asthma so PCP sent me to the pulmonologist for a full work up; congestive heart related to wt so pcp sent me to cardiologist for stress test and full work up). Of course my partner was my PCP who I had seen for 23+ years; who knew my journey; who had been through the wt loss 50+ to the wt gain 75+ again and again. My PCP, like myself, felt the insurance companies hope you will just give up, or quit and go to another job, or your company will change insurance companies or plans before you can fight long enough for the surgery to be covered.

Where is the justice to the American human being when insurance companies are fighting to keep the obese, OBESE! Ironically I would go to evaluation groups at the hospitals and be so discouraged when I left because over half the people there were being covered fully by medicare subsidized insurance like welfare. So, I was paying insurance for them out of my tax dollars and couldnt get the procedure myself. Talk about irony. Yes, I did think about quitting my job, divorcing my husband and getting on public assistance to pay for my surgery. I just couldnt do it. Yes I agree these people should get the surgery, they found statistically 45% after having the surgery; lost the weight; and returned to work within 2 years. WOW!!! That's ok. I didnt want the system changed for those who could get the surgery covered, just for those who couldnt.

This is not a surgery that anyone I know has taken lightly. Again I remind you I am a nurse so I have sought out people beyond the success stories, I wanted the full picture. Honestly, even those with the horror stories would have the surgery again even knowing what they had been through. I had even touched with those who had lost their life to the surgery.

To want this surgery to the point of getting this surgery takes sometimes years of hard work; food diaries; tests upon tests and keeping those tests and labs up to date; jumping through hoops; a positive attitude; the drive to pursue it; counseling pre and post surgery; costly nutrition and supplements; and you need an army of support people to keep you going, not for you to become dependent on but to kick you in the butt when you slow down.

So finally aback to the fluke. I found an awesome job, great to provide my post surgical care. A really great team to work with and out of my home. How much better can it get. Great pay, hmmm, getting better. Here's the funny part..... I was working as a contractor for insurance companies. LOL. Well the insurance didnt cover the surgery..... not giving up.... nope... The company was bought by another really terrific company and at the last minute and I mean last minute;  my company took on the mother companies insurance, like we had one week to complete the forms for the insurance to go effective 1 1 08... Ok well lets see, I couldnt find any of the typical exclusion structures I was sooo getting used to so hmmmmm maybe there's the light; 1/1/08 rolled around; I called the insurance company after searching out the books, online and found nothing saying it was excluded. Holy mother of GOD I hit the lottery!!!!! Gastric Bypass was covered.

On June 30, 2008 I had the surgery. Laproscopic, five punch holes and a drain hole. 27 weeks, 100# down so far, all healed. Doing great. Working out 4 times a week at the YMCA. Loving my life.

Here''s the next kicker; new insurance came out 11/08, lesser coverage; no coverage for any type gastric procedure or lap band, nothing for morbid obesity; nothing for the gym membership which the insurance paid 150.00 towards the year before. Only myself and one other person got through the procedure in time. How heart breaking for those left behind. Another person went out of state to Michigan to have vertical sleeve done for 12,000 cash, how said like a back alley... well lets not go there.

To all of you out there. SMILE, push Forward, it WILL happen, you CAN do it, Do Not give up. Some how this epidemic of obesity and the need for morbid obesity procedures needs to touch the hearts and heads of politicians so there is universal coverage. It will happen, keep the faith. When enough public figures get on board, enough Hollywood involvement, maybe a movie that makes it the BUZZ of the country..... it will happen, you will be here to see it happen.... stay tuned.

 
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