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  1. #1
    Gastric Sleeve Member Doodle_mom's Avatar
    I have had a gastric sleeve.
    Surgery date
    04/05/2017
    Surgeon
    Sherman Yu
    Join Date
    Aug 2016
    Last Activity
    07-31-2018 09:50 PM
    Location
    Galveston County
    Posts
    78
    Said "Thanks" 56 Times
    Was Thanked 63 Times in 44 Posts
    Said "Welcome to Gastric Sleeve" 8 Times

    Default So, I cried today

    After completing all of my pre-requisite counseling, classes, and clearances, and being over $500 into the process, my doctor submitted my case to the insurance company only to be told that I have to be under their policy for 36 months before they would consider paying for the surgery. I feel like this should have been explained to me before when the doctor's office checked to see if my insurance would cover the procedure. I cannot begin to tell you all how upset and disappointed I am now.




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  4. #2
    Gastric Sleeve Member Gingersnapp's Avatar
    I have had a gastric sleeve.
    Name
    Sherri
    Surgery date
    09/30/2016
    Surgeon
    Dr. Marcelo Hernandez
    Join Date
    Sep 2016
    Last Activity
    06-30-2017 07:00 AM
    Location
    Indiana
    Posts
    69
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    Was Thanked 33 Times in 29 Posts
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    Default Re: So, I cried today

    I am so sorry to hear this. My insurance doesn't cover the surgery at all, so I had mine done in Mexico. It was a great experience and very reasonable priced. $3799 included everything except my plane ticket to get there. And you won't have to wait forever! Just a thought



  5. #3
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Name
    Lisa
    Surgery date
    12/16/2016
    Surgeon
    Dr. Marcelo Hernandez
    Join Date
    Sep 2016
    Location
    Connecticut
    Posts
    22
    Said "Thanks" 2 Times
    Was Thanked 18 Times in 13 Posts
    Said "Welcome to Gastric Sleeve" 26 Times

    Default Re: So, I cried today

    My insurance doesn't cover it either so I'm paying for it I'm scheduled for December 16th 2016 with Dr Marcelo Hernandez they allow me to pay toward my balance until you're ready you should seriously consider that don't give up your dreams
    296l lbs highest weight
    284 lbsl. Post pre op diet
    M1 258 (-26)
    M2
    M3
    M4
    M5

  6. #4
    Gastric Sleeve Member Doodle_mom's Avatar
    I have had a gastric sleeve.
    Surgery date
    04/05/2017
    Surgeon
    Sherman Yu
    Join Date
    Aug 2016
    Last Activity
    07-31-2018 09:50 PM
    Location
    Galveston County
    Posts
    78
    Said "Thanks" 56 Times
    Was Thanked 63 Times in 44 Posts
    Said "Welcome to Gastric Sleeve" 8 Times

    Default Re: So, I cried today

    My insurance will pay for it. My doctor's office checked that before I began the whole process, but somewhere in the conversation they had with the insurance company, someone either neglected, or someone did not hear the part about me needing to be covered for 36 mos. first.

    I know a lot of people go to Mexico for the procedure, but my family would absolutely have a cow if I did. I have already talked about it and they are like "no way". I need to do more research on the Mexico option.

    Thanks for listening to me.



  7. #5
    Gastric Sleeve Member barbaradear1's Avatar
    I have had a gastric sleeve.
    Name
    Barbara
    Surgery date
    08/18/2016
    Surgeon
    Dr. Jose Rodriguez
    Join Date
    Jun 2016
    Last Activity
    06-05-2017 11:06 AM
    Location
    new mexico
    Posts
    80
    Said "Thanks" 2 Times
    Was Thanked 40 Times in 35 Posts
    Said "Welcome to Gastric Sleeve" 5 Times
    Blog Entries
    15

    Default Re: So, I cried today

    I live right next to Mexico and that is where I went for the surgery because my insurance doesn't cover the surgery at all. My doctor actually recommended it and a month later my husband had to have a minor surgery here that was somewhat covered by my crappy insurance. Mexico was AMAZING! They had all my FMLA paperwork filled out properly the first time around and they took great care of me while I was over there. I was in surgery 1 month after filling out the paperwork to do it. The $500 you have already spent was all I needed to schedule my surgery. Now to my husband's surgery...It has taken my 4 years to get them to do this surgery for him, I paid out of pocket the same that I did in Mexico and this was a covered surgery. It took the states doctors FIVE attempts to fill out the FMLA paperwork correctly because they don't read the whole thing. I was almost declined because it was getting close to the deadline. His experience in the hospital was not near as pleasant as mine was, the nurses are rude, the doctor barely sees him and his issue is still not resolved. So, we will probably be going to Mexico to find out what exactly we need to do to correct this issue.

    So, all in all...I am ready to drop insurance, pay the stupid fine Obama has put on our country for not having insurance and just go to Mexico for any and all medical treatment I may need.



    Highest Wt: 299 (2010)
    Pre-Op Diet: 274; (08/01/2016)
    Day of Surgery: 264 (08/06/2016)
    Goal weight: 180 lb
    After Surgery:
    1 day: 266
    1wk: 252.1 (08/25/2016)
    2nd wk: 245 (09/01/2016)
    3rd wk: 243 (09/08/2016)
    4th wk: 242 (09/16/2016)
    M1- 242 (-22)
    M2-227 (-15)
    M3 (11/18/2016): 219 (-8)

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  9. #6
    sraebaer
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    Default Re: So, I cried today

    I would fight for that $500 back!

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  11. #7
    Gastric Sleeve Member jamma's Avatar
    I have not had a gastric sleeve.
    Surgery date
    10/26/2016
    Surgeon
    Taiwan Kim
    Join Date
    Sep 2016
    Last Activity
    08-02-2019 07:10 AM
    Location
    Skaneateles, NY
    Posts
    264
    Said "Thanks" 4 Times
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    Default Re: So, I cried today

    How much more time until you are covered for 36 months? It may be worth the wait. My insurance will cover the procedure and up to two days in the hospital. I had to jump through hoops and see a psychologist, cardiologist, sleep center testing, letter from PCP, nutrition counseling. But now it will be completely paid for and I think that is worth it, because I will use the money towards new clothes, possible plastic surgery, personal trainer.



  12. #8
    Gastric Sleeve Member heathergardner14's Avatar
    Surgery date
    10/11/2016
    Surgeon
    Dr Maytorena
    Join Date
    Oct 2016
    Last Activity
    12-09-2016 05:11 PM
    Posts
    7
    Said "Thanks" 2 Times
    Was Thanked 5 Times in 3 Posts
    Said "Welcome to Gastric Sleeve" 0 Times

    Default Re: So, I cried today

    I told very few people that I was going to Mexico those I did reacted like I was going in a back alley. From the moment we pulled into mexico it felt no different than any other large city. We went straight to the facility. So clean so modern and very chic. All white and gorgeous. The place I went they only do 4 a day. No regrets $3,000 and I am onto the rest of my life. I feel pretty decent 5 days out



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  14. #9
    Gastric Sleeve Member KariVSG's Avatar
    I have had a gastric sleeve.
    Name
    Kari
    Surgery date
    11/08/2016
    Surgeon
    Dr. Kaplan
    Join Date
    May 2016
    Last Activity
    05-09-2021 02:38 AM
    Location
    West Virginia
    Posts
    554
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    Was Thanked 200 Times in 182 Posts
    Said "Welcome to Gastric Sleeve" 495 Times
    Blog Entries
    33

    Default Re: So, I cried today

    This happened to me in 2013 i went thru all of the 12 month doctor visits and nutritionist visits also paid $500 for a psych visit and on my very last visit the doctor told me to go home get all of my things ready and he will call me with a surgery time and date. Well, 2 days later his OFFICE NURSE called me and told me that I didn't have bariatric coverage on my insurance. They were supposed to check this out after my seminar but i guess i fell in the cracks. Lets just say i was pissed to high heaven. But 3 years later I called the insurance myself, They approved it and my surgery is scheduled for November the 8th



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  16. #10
    Gastric Sleeve Member KariVSG's Avatar
    I have had a gastric sleeve.
    Name
    Kari
    Surgery date
    11/08/2016
    Surgeon
    Dr. Kaplan
    Join Date
    May 2016
    Last Activity
    05-09-2021 02:38 AM
    Location
    West Virginia
    Posts
    554
    Said "Thanks" 352 Times
    Was Thanked 200 Times in 182 Posts
    Said "Welcome to Gastric Sleeve" 495 Times
    Blog Entries
    33

    Default Re: So, I cried today

    I agree Tell them they owe you!!!



  17. #11
    Gastric Sleeve Member
    I have had a gastric sleeve.
    Name
    Cindy
    Surgery date
    08/21/2017
    Surgeon
    Dr. Martin
    Join Date
    Oct 2016
    Last Activity
    11-10-2017 07:42 PM
    Location
    Greensboro, NC
    Posts
    4
    Said "Thanks" 5 Times
    Was Thanked 2 Times in 2 Posts
    Said "Welcome to Gastric Sleeve" 7 Times

    Default Re: So, I cried today

    I'm so sorry that you had that happen to you. Please try to stay positive if you can. There are always obstacles down our paths that make us want to give up. Stay the course...I believe it'll be worth it!


  18. #12
    Gastric Sleeve Member Lisa73me's Avatar
    I have had a gastric sleeve.
    Name
    Lisa
    Surgery date
    01/03/2017
    Surgeon
    Dr. Marcelo Hernandez
    Join Date
    Oct 2016
    Last Activity
    12-21-2018 09:19 AM
    Location
    Fort Worth TX
    Posts
    426
    Said "Thanks" 774 Times
    Was Thanked 242 Times in 169 Posts
    Said "Welcome to Gastric Sleeve" 1,104 Times

    Default Re: So, I cried today

    Hello,
    I'm so sorry to hear your insurance won't pay. I'm going to Mexico to have mine. A coworker went & said everything was great! I'm going to see Dr Marcelo Hernandez and it's going to cost $3799. I don't have to wait and jump through insurance hoops. My surgery date is January 3rd, and I can't wait! The only reason why am waiting that long is because I'm working on my bachelors degree and going to school. I had a scare a couple of days ago thinking I wasn't going to get to go and I was crashed, I know it's a terrible feeling to think you might have finally found the answer, just to have it pulled away. I'm going to go over winter break. I saw were a couple of other people suggested Mexico, I think you should really look into it and research it. If I were you I'd book Mexico and try to get your $500 back. Good luck!



  19. #13
    Gastric Sleeve Member Doodle_mom's Avatar
    I have had a gastric sleeve.
    Surgery date
    04/05/2017
    Surgeon
    Sherman Yu
    Join Date
    Aug 2016
    Last Activity
    07-31-2018 09:50 PM
    Location
    Galveston County
    Posts
    78
    Said "Thanks" 56 Times
    Was Thanked 63 Times in 44 Posts
    Said "Welcome to Gastric Sleeve" 8 Times

    Default Re: So, I cried today

    Two more years to meet the 36 mos.



  20. #14
    Gastric Sleeve Member Doodle_mom's Avatar
    I have had a gastric sleeve.
    Surgery date
    04/05/2017
    Surgeon
    Sherman Yu
    Join Date
    Aug 2016
    Last Activity
    07-31-2018 09:50 PM
    Location
    Galveston County
    Posts
    78
    Said "Thanks" 56 Times
    Was Thanked 63 Times in 44 Posts
    Said "Welcome to Gastric Sleeve" 8 Times

    Default Re: So, I cried today

    i really cannot recoup the $500 because I went to a physician in my town for the cardiac clearance and psychologist in my town for the pyschological clearance. Neither are affiliated with the surgeon. The rest of the money was for weight management and nutrition classes which was conducted by my surgeon's office online.



  21. #15
    Gastric Sleeve Member Lisa73me's Avatar
    I have had a gastric sleeve.
    Name
    Lisa
    Surgery date
    01/03/2017
    Surgeon
    Dr. Marcelo Hernandez
    Join Date
    Oct 2016
    Last Activity
    12-21-2018 09:19 AM
    Location
    Fort Worth TX
    Posts
    426
    Said "Thanks" 774 Times
    Was Thanked 242 Times in 169 Posts
    Said "Welcome to Gastric Sleeve" 1,104 Times

    Default Re: So, I cried today

    Just come up with about $4500, I don't know how much your deductible with your insurance was, but if you don't want to wait another two years that's what I would do. The surgery is only about $3800, but you will have to pay for airfare and need to take a little money with you. I'm going to borrow against the equity in my pickup from my credit union to make the trip. I'm so sorry that this happened to you, but I would not wait another two years to change your life. I have read a lot and studied a lot on all of this. Mexico is totally safe, and everyone that I have talked to, read blogs about, and watch their videos on YouTube all say the only regret they have is that they didn't do it sooner. There have been a couple of instances where I read where something went wrong with surgery in Mexico, but there were only two. There was a man here locally, I'm in Fort Worth, that had a very serious complication that was the surgeon's mistake. That happened right here in the states. If you can afford it, just go to Mexico and have it done. You've already gone through all the classes and know everything you need to know about the actual procedure. Anyway, I hope this helps and I hope you get your surgery one way or the other. I myself can't wait until January 3!



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