Re: coverage research continues

[Guest guest]

The RNY is not the DS. If there is no DS surgeon in network, your insurer

should provide one for you, even if they are out of network. The RNY is a

poor choice of surgeries and will leave you with problems for the rest of

your life. Don't fall for this.

Best -

Nick in Sage

coverage research continues

> Hello,

>

> As I continue my insurance coverage research, I reread my exclusion

> for my insurance plan to see exactly what was covered and not. I read

> that anything for weight loss or control is not covered EXCEPT in the

> diagnosis of morbid obesity. For my circumstances that is good.

>

> Then I wanted to search for doctors in my netwoek that may do the DS.

> I found a few doctors that do WLS, but all fo the do the RNY. I

> emailed on of the, a Dr. Kamelgard in UMDNJ, and he says that they

> have performed the Duodenal Switch, but prefer the RNY. He also says

> the total cost for the RNY would be about $20,000 out of pocket. Now

> if he is a good docotr, and willing to do the DS, then this would be

> great for me. It would all be covered it seems.

>

> Have any of you had any experience with Dr. Kamelgard? I am hesitant

> to pursue the DS with someone that really doesn't prefer it. And of

> coruse, I am speaking way ahed of myself because I do not know if I

> am even going to go through the surgery, but I do know that I have to

> have it covered or I wouldn't even consider it.

>

> Thanks,

>

>

>

>

>

>

> ----------------------------------------------------------------------

>

[Guest guest]

,

I would also add that I would never let a surgeon who has done less

than 75 DS surgeries practice on me even if I could convince them. It

is an extremely complex surgery and even experienced surgeons run

into serious problems! Ok?

Hugs and good luck with your journey, sounds like you are in the

process of convincing yourself!

Theresa

Surgery date: DS Nov. 19, 2001

Dr. Gregg Jossart

Highest weight: 293

Surgery weight: 251

Current weight: 221

Height: 5' 7.5 "

> The RNY is not the DS. If there is no DS surgeon in network, your

insurer

> should provide one for you, even if they are out of network. The

RNY is a

> poor choice of surgeries and will leave you with problems for the

rest of

> your life. Don't fall for this.

>

> Best -

>

> Nick in Sage

>

> coverage research continues

>

>

> > Hello,

> >

> > As I continue my insurance coverage research, I reread my

exclusion

> > for my insurance plan to see exactly what was covered and not. I

read

> > that anything for weight loss or control is not covered EXCEPT in

the

> > diagnosis of morbid obesity. For my circumstances that is good.

> >

> > Then I wanted to search for doctors in my netwoek that may do the

DS.

> > I found a few doctors that do WLS, but all fo the do the RNY. I

> > emailed on of the, a Dr. Kamelgard in UMDNJ, and he says that they

> > have performed the Duodenal Switch, but prefer the RNY. He also

says

> > the total cost for the RNY would be about $20,000 out of pocket.

Now

> > if he is a good docotr, and willing to do the DS, then this would

be

> > great for me. It would all be covered it seems.

> >

> > Have any of you had any experience with Dr. Kamelgard? I am

hesitant

> > to pursue the DS with someone that really doesn't prefer it. And

of

> > coruse, I am speaking way ahed of myself because I do not know if

I

> > am even going to go through the surgery, but I do know that I

have to

> > have it covered or I wouldn't even consider it.

> >

> > Thanks,

> >

> >

> >

> >

> >

> >

> > ------------------------------------------------------------------

----

> >

[Guest guest]

I too am from New Jersey and have done much research in regard to weight

loss surgery. I found few if any Drs. who do the DS procedure. There are

none in South Jersey other than a Dr. Valeri Andrei at St. s Hospital in

New Brunswick, part of Wood system. I Am sure there may be

others but none I came across. There are plenty of doctors doing the RNY

procedure both via Lap and open incisions.

I am finishing up pre-op testing for the possibility of BPD/DS done by

Dr. Herron at Mount Sinai. The group of docs came highly recommended by

others on the list. I do suggest you put your name on several Drs. for

consults as the wait can be long for an appointment. You can continue your

research and be better informed by your consult. I waited almost 4 months

for the 3 consults I had.

If I can help with NJ information let me know.

Good Luck.

Liz Hershey

[Guest guest]

Thank you Liz. I thought I was the only one here from Jersey. I even

scanned other mailing lists and searched for New JErsey, and got

nothing. What insurance do you have, if you don't mind me asking?

From what I get so far, I think I may have to go out of network with

this, especially if I want to do the DS (and after reading info on

the RNY, I am SURE I want the DS) The out of pocket expenses for me

could be manageable. I think they have a max of $2000 per year. But

that is supposing the doctors whereever I go agree to BCBS customary

costs. I am not toally sure how that works. Anyway, I did think of at

least making a consultation appt. I figured I will get a checkup from

my PCP first and see where it leads. I am pathetically going back and

forth in my mind whether I want to do this. One min yes, the other

no. The only thing that makes me second guess myself is the

possibility of dying or serious complications on the operating table.

I am a worry wort to the millionth degree, and this is what goes

through my mind. Oh well, on with the research. And thanks for the

info.

>

> I too am from New Jersey and have done much research in regard

to weight

> loss surgery. I found few if any Drs. who do the DS procedure.

There are

> none in South Jersey other than a Dr. Valeri Andrei at St. s

Hospital in

> New Brunswick, part of Wood system. I Am sure there

may be

> others but none I came across. There are plenty of doctors doing

the RNY

> procedure both via Lap and open incisions.

> I am finishing up pre-op testing for the possibility of

BPD/DS done by

> Dr. Herron at Mount Sinai. The group of docs came highly

recommended by

> others on the list. I do suggest you put your name on several

Drs. for

> consults as the wait can be long for an appointment. You can

continue your

> research and be better informed by your consult. I waited almost 4

months

> for the 3 consults I had.

> If I can help with NJ information let me know.

> Good Luck.

> Liz Hershey

>

>

>

[Guest guest]

Ford,

They practice on anyone but me!

Hugs,

Theresa

> > The RNY is not the DS. If there is no DS surgeon in network, your

> insurer

> > should provide one for you, even if they are out of network. The

> RNY is a

> > poor choice of surgeries and will leave you with problems for the

> rest of

> > your life. Don't fall for this.

> >

> > Best -

> >

> > Nick in Sage

> >

> > coverage research continues

> >

> >

> > > Hello,

> > >

> > > As I continue my insurance coverage research, I reread my

> exclusion

> > > for my insurance plan to see exactly what was covered and not. I

> read

> > > that anything for weight loss or control is not covered EXCEPT

in

> the

> > > diagnosis of morbid obesity. For my circumstances that is good.

> > >

> > > Then I wanted to search for doctors in my netwoek that may do

the

> DS.

> > > I found a few doctors that do WLS, but all fo the do the RNY. I

> > > emailed on of the, a Dr. Kamelgard in UMDNJ, and he says that

they

> > > have performed the Duodenal Switch, but prefer the RNY. He also

> says

> > > the total cost for the RNY would be about $20,000 out of pocket.

> Now

> > > if he is a good docotr, and willing to do the DS, then this

would

> be

> > > great for me. It would all be covered it seems.

> > >

> > > Have any of you had any experience with Dr. Kamelgard? I am

> hesitant

> > > to pursue the DS with someone that really doesn't prefer it. And

> of

> > > coruse, I am speaking way ahed of myself because I do not know

if

> I

> > > am even going to go through the surgery, but I do know that I

> have to

> > > have it covered or I wouldn't even consider it.

> > >

> > > Thanks,

> > >

> > >

> > >

> > >

> > >

> > >

> > > ----------------------------------------------------------------

--

> ----

> > >

[Guest guest]

Liz,

I am much farther up north, by exit 150 on the GSP. THanks for the

info. If you don;t mind, I will email you privately with a couple

more questions if you don;t mind.

Thanks again,

>

> I have Amerihealth POS which ha both in and out of network

abilities. I

> did research and chatted with several people. My best

recommendation is to

> make several consult appointments so you can make informed decision

on the

> doctor you feel most comfortable with. I was fairly clear I wanted

the DS

> from the begining but explored the RNY. In fact I have a tentative

surgery

> date of 2/25 if I want the RNY and I am still completing the

requirements for

> DS surgery with Dr. Herron in NYC. Not any of the Drs. I

interviewed

> accepted in network benefits of Amerihealth. I also supposidly

have approval

> from insurance for the surgery but have yet to see it in

writting.just

> verbally from my PCP office staff.

>

> By the way what part of Jersey are you from? I am in

Burlington County

> between exits 4 and 5 of NJ Turnpike. If I can be of further help

let me

> know either through the board or email me privately....

> Best Wishes

> Liz

>

>

>