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Hi,
Anyone have any experience with Mercy? I went to a seminar last week and feel like they really have a well rounded approach to surgery. I haven't had my initial appointment yet to get some statistics on the post op complication rates so I was wondering if anyone here had any experience. Also, I have Anthem insurance and surgery is covered. Anyone have any idea what their requirements are?
I went through Mercy and have had a very good experience. I'm almost five months post surgery and have done well. The preop work was thorough, and I feel like that coupled with my own research has been excellent prep for the surgery and life after. I also have Anthem BC/BS, but my plan has specific exclusions for any kind of bariatric surgery so I self-paid. My Mercy experience has been great, although it wasn't in Cincinnati - I'm in St. Louis.
Try googling your doctor. You can usually find people's experiences with them. I would contact your insurance directly to find out the requirements so you can make sure everything gets met. I did that with mine. Good luck.
So I spoke with my insurance company today and they require that surgery be medically necessary and require a 6 month supervised diet before they'll approve. I dunno, maybe I'm approaching this with the wrong mindset but I can go on a diet and maybe lose a little bit of weight and they'll deny me, and I'll likely gain it all back. Or I can just get cleared for surgery and go to Mexico and get it over with.I don't want to spend the next year jumping through hoops. I just feel like the insurance company probably isn't going to approve me and they shouldn't get to decide whats best
You can also try the six months supervised diet and if they don't approve you, then you go to Mexico.
Because, let's be honest here, the six months diet is to make sure you can stick to a program, and that will be necessary for the sleeve process too. there's guidelines to follow and the weight will not be coming off if you can't follow those guidelines post-op.
I know six months is a long time but I'm pretty sure you've been obese for much much more. And what you will lose in the pre-op diet won't come back when you have the sleeve to help you.
After being obese for 20 years I was ready for the sleeve. Since I did already a one year supervised diet, I didn't need to do an other diet to be approved, plus my BMI was around 53 and I knew that they would approve a person with a BMI higher than 40 (or lower with two comorbidities).
Because I'm overseas, my insurance is different, but I do think that this surgery should be paid for by our insurances because it's not a luxury but a necessity. If you can get it paid by your insurance, go for it. It will be easier also for your after care and if you have a problem post-op (complications are low, 1% but still..).
Yes it might be more complicated than going to Mexico, but on the long run it's probably worth it.
Good luck and take care.
Hi,
I am in Cincinnati too, but I am going through the program at UC. I did my initial seminar in June 2016 and started the 6 month supervised weight-loss program, completing it in January. Trust me, it's not as bad as it sounds! During the six months you will be visit with the dietician, physician's assistant, therapist, and the surgeon. You will learn the ins and outs of the surgery and the changes you will need to make to achieve your goals. You don't have to lose a ton of weight during the supervised weight loss, in fact, I only lost about 10 pounds.
You may also need medical clearance from a cardiologist, sleep doctor, or pulmonologist. Make sure you get those done sooner rather than later! Don't be like me and keep postponing, LOL. I didn't get my pulmonary clearance until early March, so my info was just now submitted to insurance for approval. All in all, this process has taken about 9 months so far, but it's been well worth it! And at times it's seemed to take forever, but most of the time it's flown by! Best of luck on your journey! Let me know if you'd like a local support buddy!
Deanna
If you enter into a program with your gastric surgeon for the six month supervised diet, the weight you entered is your starting weight. So if you lose during the supervised diet, the insurance company does not deny you based on that. On my program (which was totally paid for by insurance except $150 and co-pays) I had to have a BMI over 40 (which I did not have) so if not, you had to have 2 co-morbidities; believe me, the doctors are very good at finding co-morbidities, so if they accept you as a patient, you most likely will not be denied. I, too, was upset about the six months, but in the end, as someone else said, you HAVE been obese for longer than that. I liked having insurance pay for it, so that was good enough for me.
I've been mulling it over and I'm going to go ahead and wait for the center here to get me in and go from there. I certainly don't want to run into this and I want to be sure I'm medically approved for a surgery. I've had a really bad past few months so I think the diet will be good to get me back into a better eating groove and working out. If I go through all of it and don't get approved, then off to Mexico I go. I don't think my insurance will cover the diet unless the dr convinces them it's medically necessary. I got the general feeling at the seminar that they're very good at working with the insurance companies and they have such a well rounded program I'd prefer to wait and see what happens here. I'm just so excited about the possibilities.
I am also having surgery at the mercy weight loss solutions.