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  642 People Lost in total 56560 lbs = 29.14 % Give us permission to add your before & after Weight Loss Photos |   |
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08-07-2006, 01:47 PM
| #1 (permalink) |
| WLS Guru  Join Date: Jul 2006 Location: mississippi
Posts: 353
Weight Statistics January 2007 Start Date:
May/June??? Surgery Date:
Height: 350 lb Start Weight:
330 lb Current Weight:
200 lb Goal Weight:
20 lb Weight Loss:
130 lb Lb Left to Lose:
5.71428571429 % % Lost:
December Goal Date:
Body Mass Index 54 BMI Start:
53 BMI Current:
31 BMI Goal:
Weight Loss Method Controlled Eating & Exercise   |  insurance sucks Well I got my answer today......they denied my coverage for the surgery. Need 6 mo supervised weight loss, no evidence of need, etc etc.... What the heck....I am 5'7 and weigh 342 lbs.......what more evidence do you need. The weight just didn't come on overnight, I need help!!! I am so frustrated right now! I have done all the crap I thought I had to do, dr visits out the wazoo, poked, prodded what ever they told me to do I have done it. Do I have incompetant Dr's offices, what is going on here!  I just don't know if I can really do all the crap they want me to do. This sucks! I think I may be fat forever  .
__________________  MSmOm   |
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Yes, you can often get insurance cover for your Weight Loss Surgery. Our own Craig "Big-T" Thompson has been there and done that, and he's written an e-book about it.  |
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08-07-2006, 09:59 PM
| #2 (permalink) |
| Super Moderator  |  Mom, don't be discouraged first round. Go over the fine points of the denial with your dr and pick it apart. Many insurance companies require supervised diet from 6 to 12 mos these days. Do whatever you need to do to fulfil their requirements. You need to fight to get approval, and it takes a number of rounds with the insurance co to get it for many, many people. Have you taken a look at Craig's Insurance book yet? If not, check it out and tackle 'em again. Perseverance Prevails!!! ((((((((HUGS)))))))))
__________________ "In every job that must be done, there is an element of fun."   Just a li'l bit 'bout myself  Last edited by DocSanae : 08-08-2006 at 07:17 AM. |
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08-08-2006, 07:15 AM
| #3 (permalink) |
| Seasoned Veteran  Join Date: May 2006
Posts: 1,996
5/17/06 Start Date:
5' 6" Height: | I have a friend who the same thing happened to. She started the supervised weight loss as soon as she found out and now is only a month away. Don't give up. You are worth the effort! Kat |
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08-08-2006, 10:28 AM
| #4 (permalink) |
| WLS Master Guru  Join Date: Feb 2006 Location: Near St. Louis, MO
Posts: 633
Weight Statistics June 17, 2005 Start Date:
June 17, 2005 Surgery Date:
5' 2" Height: 313 lb Start Weight:
173 lb Current Weight:
140 lb Goal Weight:
140 lb Weight Loss:
33 lb Lb Left to Lose:
44.7284345048 % % Lost:
don't have a set goal date, I take it day by day that way I don't get discouraged Goal Date:
Body Mass Index 57.2421956296 BMI Start:
31.6386576483 BMI Current:
25.6035379813 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass  | First off.... Don't give up. If you really want to have it done, don't let them win. Most insurances now require 6 to 12 month supervised diet. Make an appointment today with your dr's office and have them start tracking your weight every month. Continue to see a dietician. Take pictures of yourself to submit with your paperwork. Did you have to write a letter to your insurance company telling them why you wanted to have the surgery? I did. If you need some help with that, I can send you a copy of mine. If they ask you to bend over and jump backwards through hoops, at this point ya gotta do it!!!!! Please let us know if there is anything we can do to help you get approved. We are here to support you every step of the way. Hugs, Shelley
__________________  ShelleyHe who finds diamonds must grapple in mud and mire because diamonds are not found in polished stones. They are made.   |
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08-08-2006, 11:58 AM
| #5 (permalink) |
| Big Loser  Join Date: Jun 2006 Location: Massachusetts
Posts: 156
Weight Statistics 7/26/06 Start Date:
10/3/06 Surgery Date:
Height: 314 lb Start Weight:
145 lb Current Weight:
145 lb Goal Weight:
169 lb Weight Loss:
53.821656051 % % Lost:
10/3/07 Goal Date:
Body Mass Index 52 BMI Start:
24 BMI Current:
24 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | I am so sorry that they didnt approve you. Blue cross approved me right off the bat. I was 309 and 5'4" when I saw my surgeon for the first time. My primary care signed off on my paper work right away. I am happy that my approval was easy. I am so sorry that you have to go through this. You should see what you doctor has for dates and weights of your weigh-in's If you had to go to the doctor for other stuff they always take your weight right? If so maybe you can use that towards the 6 month diet history, If I were you I would call and ask The insurance company for a copy of surgery requirements. This way you and your doctor can go through them with a fine tooth comb and then after all requrements have been met send it all in with proof that you did this, and write a letter telling them about why you want and need the surgery. Also most insurance companys will ask you how long you have been at this weight for, in most cases you have to be the 100 lbs overweight for at least 5 years. Good luck and keep us informed.
__________________ Jessica  Surgery date 10/3/06   My before pictures http://s102.photobucket.com/albums/m94/JLR12679/ Follow my WLS journey here: http://tazdevil12679.blogspot.com/ My myspace website http://www.myspace.com/jess12679  |
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08-08-2006, 01:07 PM
| #6 (permalink) |
| WLS Guru Join Date: Jul 2006 Location: mississippi
Posts: 353
Weight Statistics January 2007 Start Date:
May/June??? Surgery Date:
Height: 350 lb Start Weight:
330 lb Current Weight:
200 lb Goal Weight:
20 lb Weight Loss:
130 lb Lb Left to Lose:
5.71428571429 % % Lost:
December Goal Date:
Body Mass Index 54 BMI Start:
53 BMI Current:
31 BMI Goal:
Weight Loss Method Controlled Eating & Exercise | THANK YOU GUYS!!!! So much!!! I needed to hear all of that. I am going to keep fighting and fighting, I was in a place yesterday. Thank you for listening to my rantings! I am still disappointed but I plan to follow it through. I started in April going through all of this. I just want it to be over with. I knew it wasn't going to be easy. I tried to prepare myself for the worse, but of course my emotions got the better of me. I am going to appeal the decision and do my 6 mos. supervised. My plan will allow me to do weight watchers as my supervised weight loss so, I guess off to weight watchers I go. I have been on the diet before but did not attend the meetings. My Dr's office suggested that I get on it anyway to help me train myself to stick to a diet. I will continue my battle. Thanks for all of the support!!
__________________ MSmOm |
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08-08-2006, 03:16 PM
| #7 (permalink) |
| Seasoned Veteran  Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,756
Weight Statistics June 1, 2005 Start Date:
Height: 310 lb Start Weight:
167 lb Current Weight:
159 lb Goal Weight:
143 lb Weight Loss:
8 lb Lb Left to Lose:
46.1290322581 % % Lost:
Body Mass Index 51 BMI Start:
27 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass  | ((((((((((TIGHTHUGS))))))))))))) i know hearing this 6 months of supervised diet thing is hard. BUT i am hearing the insurance companies wanting this alot more and more. HANG in there be strong and im sure the time will fly bye! SORRY i know at the moment its frustrating.
__________________ LISA  http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass  |
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08-08-2006, 04:19 PM
| #8 (permalink) |
| WLS Guru Join Date: Jul 2006 Location: mississippi
Posts: 353
Weight Statistics January 2007 Start Date:
May/June??? Surgery Date:
Height: 350 lb Start Weight:
330 lb Current Weight:
200 lb Goal Weight:
20 lb Weight Loss:
130 lb Lb Left to Lose:
5.71428571429 % % Lost:
December Goal Date:
Body Mass Index 54 BMI Start:
53 BMI Current:
31 BMI Goal:
Weight Loss Method Controlled Eating & Exercise | yea it is frustrating but I will get over it, February will be here in no time!! It just seems so far away. In the meantime I will keep on fighting the insurance!! Funny thing......Jessica (JLS) says she has Empire BCBS, that is the insurance I had at this time last year....I keep thinking that if I would have made this decision only one year earlier I would not be in this situation now......oh well, God works in mysterious ways and I am sure he has his reasons......Thanks for listening!!!! Dawn
__________________ MSmOm |
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08-08-2006, 06:01 PM
| #9 (permalink) |
| WLS Guru  Join Date: May 2006 Location: South Carolina
Posts: 372
Weight Statistics July 11,2006 Start Date:
July 11,2006 Surgery Date:
Height: 235 lb Start Weight:
132 lb Current Weight:
135 lb Goal Weight:
103 lb Weight Loss:
-3 lb Lb Left to Lose:
43.829787234 % % Lost:
July 11,2007 Goal Date:
Body Mass Index 41 BMI Start:
22 BMI Current:
22 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | that is so true and keep faith in that and remember all things are possible through him. Keep up the hard work and dedication! It will all be worth it in the end! hugs!! |
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08-09-2006, 12:05 PM
| #10 (permalink) |
| Seasoned Veteran  Join Date: Feb 2006 Location: McGuire Air Force Base, New Jersey, USA
Posts: 2,495
Height: | Best of luck sweetie. I know that it is hard to think of it being so far away right now, but it will get here sooner than you think and then you can be a big loser with the rest of us. Big hugg sweetie and chin up. Janae |
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