Obesity surgery

Hi group,<br> For two years I contemplated
wheather I should try for WLS or not. I am a 37 year old
Black female with malignant (as stated on my medical
records) high blood pressure. I was diagnosed at age 11,
and have suffered with it for many years. I take a
total of 7 different medications per day, and my
condition is still not under control. Two years ago I was
awarded permanent disability by Social Security due to
the fact that no doctor has been able to control my
blood pressure. I did inherit it from my family,
however I am the only one in the family who is
overweight, so this adds to the problem. <br><br> Last
Tuesday, I had a consultation with a Gastric Bypass
Surgeon, Dr. Sieloff here in Tallahassee, Florida. I’m
5′6, 235 lbs although I don’t look it. The nurse told

me that she didn’t think the doctor would recommend
the surgery for me because I don’t look as heavy as I
really am, but after weighing me she said she breathed a
sigh of relief. I actually weighed more than I thought
I weighed because I wrote 230 lbs on the form. Plus
I have co-morbities too (just a week and a half ago
I found out I am in the beginning stages of
diabetes, which also runs in my family). Good thing I found
out about it before my appointment with the
surgeon.<br><br> Anyway, the doctor is sending off for approval
from my insurance. The problem? I have
Medicare/Medicaid. Medicare does not do pre-certs, they tell the
doctors to go ahead with the surgery and they will pay if
it was a medical necessity, plus the surgeon has to
be in Medicare’s physician network. Medicaid will
approve the surgery. The problem? My Medicaid is
secondary to Medicare. Medicaid will only pay what Medicare
does not cover. Forgive me for being so long winded,
but I am worried that I won’t get coverage for this
doctor to perform the WLS. There aren’t many doctors
here in Tallahassee who perform the surgery, and I
hate the thought of going out of town and being all
alone.<br><br> So right now I am weighting (waiting) for
approval or rejection from Medicare. The doctor said he
would also send for approval from Medicaid, so I’m
waiting for both to either approve or reject me. Keep
your fingers crossed and say a prayer for me. Thanks
Knee

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