Thanks ! (was Re: trying to decide)

[Guest guest]

If your policy says specifically that they do not cover WLS, then you

are probably out of luck, that's why I said " If your policy doesn't

say that . . . " But no reason not to give it a shot.

If you can prove it's medically necessary, you may throw the ball

back

in their court. Good luck.

>

>

>

> >From: " "

>

> The question was asked:

> > > want to know; why did you choose the mini?

>

> answered:

> >

> >Much less time in surgery and under anesthesia (30 minutes, as

> >compared to 4-8 hours), super fast recovery time (less than 24

> >hours),

> >great doctor that is well liked by all his patients (I interviewed

97

> >of his patients and *all* of them love him, even the few who had

some

> >kind of complication).

>

>

>

> That is exactly why, after over 9 years of researching different

WLS

> options, I have decided to start the aproval process. (with

fingers

crossed

> tightly. *chuckle*) The MGB defintely is the one I feel strongly

about.

>

>

> >See the paper Dr. Rutledge prepared for the

> >American Society of Bariatric Surgeons (ASBS) conference that's

> >coming

> >up. Right now, the MGB is the leader in weight loss.

>

>

> I really enjoyed the paper too. So much, in fact I've printed it

up, along

> with the patient education manual, and Dr. Rutledge's letter to

PCP's from

> the www.clos.net website to present to my PCP, when I go to pick up

the

> oximeter for my overnight oxygen saturation monitoring... to see if

further

> sleep apnea testing is needed. I'm so glad to have access to this

great

> info to give my doctor. (I don't think it'll be a problem, since

my

PCP is

> anxious to have me back in the ICU assisting him with procedures.

*smile*)

>

>

> >

> > > What about insurance

> > > acceptance? I've got Partners. I'm afraid they don't accept WLS.

> >

> >*IF* there is no specific exemption in your policy that says

> >something

> >like " we don't cover weight loss surgery, " then the biggest hurdle

> >will be to prove that the surgery is " medically necessary. "

> >

> >You do this on your patient information form, which Dr. R. will be

> >sending to your insurance company. You want to show your

> >weight is more than 100 pounds over your ideal weight, along with

> >*EVERY SINGLE POSSIBLE PROBLEM FROM BEING OVERWEIGHT YOU CAN THINK

> >OF*

>

>

> All I can say is, " WOW!! " Since my policy, ODS/Blue Cross PPO,

explicitly

> states that WLS is not covered I'd totally written it off and

raised

the

> funds to self pay. (Read: robbed my retirement fund and started a

> home/internet based business.) This is possibly good news. Thanks

for

> giving me a bit of hope in this area, .

>

> Thanks again. I really appriciate the confirmation on what I've

seen

> regarding MGB!!

>

> Walk in Peace;

>

> Jenn (32 y/o, 301#)

> Vancouver, WA

>

> Visualizing the other side, where I'm able to go back to hospital

work and

> have energy to increase my business. (WOOHOO!!)

>

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