Hello I'm Michelle. I have been trying to have gastric surgery for more than 5 years. Once I established that it was a medical necessity I looked long and hard for my specialist. I completed every pre op requirement including establishing a pattern of diet, psych , and multiple specialist. Three days into my pre op liquids stage the doctors office infirmed me that I wasn't covered by insurance after all. I kept calm and started appealing insurance. I thought surely, this was obviously medically necessary. after 9 appeals over a number of years, I just kinda accepted that my lifespan would be considerably shorter than most due to Obesity. then the owner of the company I work for asked "what can we do?" Hope again! Another year passed while my companies battled and appealed insurance as well. in the end it would have cost the company an obscene amount of money to have this inclusion added to our policy, and not just once but annually. and so I decided to just give up. less than a month after that, my employer called me aside. Honestly, I thought they were going to dismiss me,. Due to my health issues I was struggling. Instead he said to me words that Ill carry forever. "Michelle, I'm ready for you to be a testament. the company is going to help you figure out getting this surgery." And they did! My employer matched every dollar that coworkers and friends donated! I returned to my surgeon cash in hand, and thought this is it. they informed me that since my original cash quote was for sleeve surgery, with the new health conditions like Diabetes that bypass was necessary. So more money needed and a surgeon now out of my price range. So I started contemplating Mexico and out of state. Honestly at that point, I probably would have let anyone do the procedure. Then out of the blue I receive a phone call from my original Surgeon's office manager. They had spent weeks searching for a location to do the surgery for what money I have! and even came in just a bit under the total amount raised, so that I could be sure to get my vitamins and meal replacements for a year. Today I met with my surgeon again. I was so happy that I actually hugged the man before I thought about what I was doing! Later I had a refresher with the dietician, who said I was the most prepared/ informed pre op patient she'd ever met. tomorrow I will schedule, so I believe the week of July tenth! I'm here because though I have wonderful supportive friends and family who have done anything and everything to get to this point... They still don't understand so much at the end of the day. I almost feel like I am in shock or on autopilot. Like this isn't really my life. Someone please tell me this is normal.
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Just a few more days!
- Thread starter virgo77
- Start date
Thanks so much! I did explore all charity programs in my area as well as applying for the national scholarship. Unfortunately my local hospitals still consider this cosmetic and would not help. Honestly I was blessed before being contacted by the scholarship foundation.Wow, Michelle, what a great story. You have been really blessed to be in contact with so many people who wanted to make this happen. I'm really shocked at the insurance company's initial contacts, though I do understand the danger of setting precedents in coverage. However, those exceptions are really part of the bigotry society has against the obese, & even the overweight who are not classified as obese.
I want to add one very important thing. I don't know of a major metropolitan hospital that doesn't have a "charity care" program, or something like it. I have benefitted twice from charity care. The first time was with my RYGB surgery. Medicare only covered 80 percent 12 years ago. The surgeon first wrote a letter to Medicare explaining this was a medical necessity for me. Then the hospital kicked in the extra 20 percent & all my post-op nutritional counseling.
Please hang out & read our stories, & let us follow your journey. This IS your life! This is really happening! & it's only the beginning. I want to say, & believe I can also speak for the group (though they will surely kick in & express themselves soon) your donors, coworkers, boss, family & friends are the most wonderful people. You're young & you'll heal well & use the tool of surgery to change your health & your life. Welcome to our group!
I will be scheduling my surgery tomorrow or Monday. Hoping for the week of the tenth!!SO HAVE YOU HAD THE SURGERY YET AND IF SO HOW ARE YOUR DOING