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Old 08-21-2009, 11:14 PM   #1 (permalink)
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Join Date: Jan 2009
Posts: 971

Weight Statistics

All of my life!
Start Date:
12/01/08
Surgery Date:
5' 6"
Height:
309 lb
Start Weight:
178 lb
Current Weight:
170 lb
Goal Weight:
131 lb
Weight Loss:
8 lb
Lb Left to Lose:
42.3948220065 %
% Lost:
Original 12/09 Actual 09/09
Goal Date:

Body Mass Index
49.8684573003
BMI Start:
28.7268135904
BMI Current:
27.4357208448
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default Steps to PS ...

Ok so I saw my PCP for the 1st time to discuss my chronic mid/lower/hip pain. We have decided to take steps for the insurance company to see that I am trying every route before PS. PCP wrote a referral for physical therapy. If it does not work they will have the documentation that it more then just muscular pain. In other words that it is the extra skin that is causing the problem. In the mean time I will meet with the PS to discuss how long he wants me to wait to even have PS. My PCP said that she wants my only to take Tylenol 1st. It has been working fairly well, it does not take all the pain away but it eases it. I am already on some other meds for my bi-polar/depression/anxiety and they do not want to add anything else at this time. I am ok with that as I already a walking pharmacy. So laying the ground work if I end up wanting the PS. In the end I might decided not to have it but if I do then I will have the documentation to send to the insurance company for them to cover it. They said there was a high likely hood that they would cover it as it is cheaper to have it done then to have to deal with the chronic appointments to the PCP to manage pain.

So we will see how the physical therapy goes. I will go in for an evaluation and then they will tell me how often I will go, etc.
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Alt Weight Loss Surgery Insurance
Yes, you can often get insurance cover for your Weight Loss Surgery.
Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.

   
Old 08-22-2009, 12:03 AM   #2 (permalink)
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5' 5"
Height:
Default

Hang in there, hope all goes well.
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Old 08-22-2009, 06:12 AM   #3 (permalink)
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Join Date: Aug 2006
Location: Saint Louis
Posts: 1,477

Weight Statistics

5/6/08
Surgery Date:
5' 10"
Height:
325 lb
Start Weight:
149 lb
Current Weight:
150 lb
Goal Weight:
176 lb
Weight Loss:
-1 lb
Lb Left to Lose:
54.1538461538 %
% Lost:

Body Mass Index
46.6275510204
BMI Start:
21.3769387755
BMI Current:
21.5204081633
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

hope you are able to get the documentation you need so that the insurance company will pay for your ps ! that would be AWESOME!
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DePaul Weight Loss Institute
Saint Louis, Mo - May 6, 2008

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Old 08-22-2009, 08:02 AM   #4 (permalink)
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Join Date: Jan 2009
Posts: 971

Weight Statistics

All of my life!
Start Date:
12/01/08
Surgery Date:
5' 6"
Height:
309 lb
Start Weight:
178 lb
Current Weight:
170 lb
Goal Weight:
131 lb
Weight Loss:
8 lb
Lb Left to Lose:
42.3948220065 %
% Lost:
Original 12/09 Actual 09/09
Goal Date:

Body Mass Index
49.8684573003
BMI Start:
28.7268135904
BMI Current:
27.4357208448
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

I can't believe that they would even consider it. I figured whats the harm in trying to do what they ask.
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Old 08-22-2009, 08:44 AM   #5 (permalink)
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Join Date: Mar 2007
Location: Floyd County Virginia
Posts: 10,124
Blog Entries: 6

Weight Statistics

September 19th 2007
Start Date:
September 19th 2007and June 18,2012
Surgery Date:
5' 10"
Height:
363 lb
Start Weight:
192 lb
Current Weight:
190 lb
Goal Weight:
171 lb
Weight Loss:
2 lb
Lb Left to Lose:
47.1074380165 %
% Lost:
When I get there again
Goal Date:

Body Mass Index
52.0793877551
BMI Start:
27.546122449
BMI Current:
27.2591836735
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

I think this is a good way to go at it. The physcial thearpy may help with that pain. Lets hope it does. It would be great to have the PS paid for because of the chronic pain. I think your approaching this the way it should be. Good luck with all this and I hope that you find some pain relief.
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Old 08-22-2009, 09:12 AM   #6 (permalink)
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Join Date: Aug 2006
Location: Saint Louis
Posts: 1,477

Weight Statistics

5/6/08
Surgery Date:
5' 10"
Height:
325 lb
Start Weight:
149 lb
Current Weight:
150 lb
Goal Weight:
176 lb
Weight Loss:
-1 lb
Lb Left to Lose:
54.1538461538 %
% Lost:

Body Mass Index
46.6275510204
BMI Start:
21.3769387755
BMI Current:
21.5204081633
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

that is basically my point ~ that with the chronic pain treatments you would possibly have documented proof of the benefits physically for plastic surgery. it has been my understanding that in some cases where this is proven to be medically needed (rashes that won't heal - extreme extra skin in stomach region) that insurance has paid for procedures. the most important thing is that you get relief from the pain and discomfort you are experiencing
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DePaul Weight Loss Institute
Saint Louis, Mo - May 6, 2008

_____________________________________________

"I can do all things through Christ who strengthens me." Philippians 4:13
http://joannes-journey.blogspot.com

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Old 08-29-2009, 01:29 AM   #7 (permalink)
WLS Master Guru
 
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Join Date: Jan 2009
Posts: 971

Weight Statistics

All of my life!
Start Date:
12/01/08
Surgery Date:
5' 6"
Height:
309 lb
Start Weight:
178 lb
Current Weight:
170 lb
Goal Weight:
131 lb
Weight Loss:
8 lb
Lb Left to Lose:
42.3948220065 %
% Lost:
Original 12/09 Actual 09/09
Goal Date:

Body Mass Index
49.8684573003
BMI Start:
28.7268135904
BMI Current:
27.4357208448
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

Update on my consult with PS. The PS noted that a Mini Tummy Tuck might be covered by insurance. If I wanted a full Tummy Tuck I could be responsible for half of the costs or all if the insurance denies ($8000 for the Full Tummy Tuck). He stated that the insurance would not pay for a Breast Lift, only a Breast Reduction. In my case I would only need skin removed thus it would be Breast Lift. Of which would cost a little over $6000. In the end it would be up to insurance whether or not there is a waiting period after I reached goal. In the end he said that the insurance company would only approve the Mini Tummy Tuck if I had extremely bad rashes. That back pain does play a roll in the process and I do not have a big enough 'apron'. He noted that I have no extra skin on my back. In fact I looked really good for the weight that has been lost in the amount of time it has taken place in. DH & I have been surprised at what my body looks like. We thought it would be much worse. I will call the insurance company for more information. Then DH & I will discuss if this is really a need. Of course if I lose anymore weight and the skin becomes too much I might change my mind.
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Old 09-01-2009, 01:41 PM   #8 (permalink)
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Join Date: Oct 2008
Posts: 306

1983
Start Date:
09/10/2008
Surgery Date:
5' 4"
Height:
246 lb
Current Weight:
170 lb
Goal Weight:
-246 lb
Weight Loss:
76 lb
Lb Left to Lose:
42.2211914062
BMI Current:
29.1772460938
BMI Goal:

Weight Loss Method
Roux en Y Gastric Bypass
Default

Good luck. Keep us informed about the insurance coverage. I am also interested in getting my insurance to pay up
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Houston, Texas

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