GingerRose
New Member
- Joined
- Dec 2, 2020
- Messages
- 4
Hi everyone -
Thanks for adding me. HW 285 SW 265 LW 195 CW 263
I did a bit of lurking and reading before posting to try and get some more info in regards to the DS.
About me - my name is Abby, I'm 40 years old and had the sleeve back in 2014 and was kinda successful with it, though I was hopeful of losing more than what I did.
After 2 miscarriages and working full time while getting my bachelors degree, any success I had went quickly to the wayside as the weight began to creep back on.
Fast forward to now and I am back up to my surgery weight and feeling defeated and ashamed.
My doctor did an EGD which found a hiatal hernia and also my GERD is causing havoc on my esophagus.
My doctor recommended the DS and we went ahead and sent it over to insurance who promptly denied for "not medically necessary."
After doing a bit more digging in my insurance, I found it does state in the policy that I have to have a BMI of 50 or over to be seen as eligible for that.
My doctor has a peer to peer set up with them for this Friday but his assistant stated she was pretty sure the decision would not be overturned as "we have this issue with BCBSIL all the time and they are rigid on that particular number." So, obviously, I am feeling even more depressed as I am following her logic that Friday will not bring about the answer I want to hear.
So here I am now and after reading through some of your posts I see that a number of you went to Mexicali Bariatric Center. I contacted them and they were quick to reply with some great information.
One big question I have for you all though is - for those that went there did you go alone or with your spouse/friend? As I am thinking about this as an option, I am curious if it would be doable to do on my own or if I would really need to have my hubby or someone with me.
Another question that I have is - in speaking with Mexicali they are able to re-sleeve and do the DS or just do the DS - just wanted to see what everyone's experiences were if they were re-sleeved and if they weren't. I am not sure what option is best so just hoping to hear and learn from your knowledge.
Thanks again for your time and help! I appreciate it
Thanks for adding me. HW 285 SW 265 LW 195 CW 263
I did a bit of lurking and reading before posting to try and get some more info in regards to the DS.
About me - my name is Abby, I'm 40 years old and had the sleeve back in 2014 and was kinda successful with it, though I was hopeful of losing more than what I did.
After 2 miscarriages and working full time while getting my bachelors degree, any success I had went quickly to the wayside as the weight began to creep back on.
Fast forward to now and I am back up to my surgery weight and feeling defeated and ashamed.
My doctor did an EGD which found a hiatal hernia and also my GERD is causing havoc on my esophagus.
My doctor recommended the DS and we went ahead and sent it over to insurance who promptly denied for "not medically necessary."
After doing a bit more digging in my insurance, I found it does state in the policy that I have to have a BMI of 50 or over to be seen as eligible for that.
My doctor has a peer to peer set up with them for this Friday but his assistant stated she was pretty sure the decision would not be overturned as "we have this issue with BCBSIL all the time and they are rigid on that particular number." So, obviously, I am feeling even more depressed as I am following her logic that Friday will not bring about the answer I want to hear.
So here I am now and after reading through some of your posts I see that a number of you went to Mexicali Bariatric Center. I contacted them and they were quick to reply with some great information.
One big question I have for you all though is - for those that went there did you go alone or with your spouse/friend? As I am thinking about this as an option, I am curious if it would be doable to do on my own or if I would really need to have my hubby or someone with me.
Another question that I have is - in speaking with Mexicali they are able to re-sleeve and do the DS or just do the DS - just wanted to see what everyone's experiences were if they were re-sleeved and if they weren't. I am not sure what option is best so just hoping to hear and learn from your knowledge.
Thanks again for your time and help! I appreciate it