DrmBig4Evr

Just an FYI, I was denied, my weight 4 years ago fell below 35, I am in the appeals process. Good luck in your endeavor! I will still be around, planning on self pay and appeal, if I win, I will submit the bill.

Yes I have the choice plan, but from what I understand mine only required over 40 bmi, the 5 year history was for under 40...you may want to clarify that. Also, I have documentation for only 09 and 10 and I had to write a letter, I did have 12 months of supervised diet and also submitted all the weight loss plans I was on like Atkins, Weight Watchers, etc. In my opinion you should get approved...let me know what happens! Good luck!

A lot of people seem to have this issue. You have a lot of history which is great compared to mine. I only provided 2009 and 2010, before that I really never went to the doctor. You can use gyne visits, etc. Make sure you write a letter along with your sumbission simply explaining that you did not see a doctor that year because you didn't have insurance, that should suffice. -Kathryn

Also, wanted to add that they do require a psych eval and sometimes a nutritional evaluation and physical before submitting.

As with anyone, each plan is different for each employer. If your insurance does cover bariatric surgery and your bmi is over 40, depending on your requirements you should get approval easily. According to my surgeon's office as well as many others on here, UHC is the best to work with for lap band, they understand the cost savings. I should have a denial or approval this week, it is taking longer for me because my bmi is right at 35. I will respond to this once I hear back. A tip would be to call UHC and see if bariatric surgery is a covered benefit under your plan, then find out what documentation you need to submit for approval. I needed 5 years of morbid obesity documentation (other peoples plans do not require this), I also needed to document any significant health issues. However, like I said, if it is covered, most insurance plans automatically cover it with a bmi of 40 or over, just make a call. Once you submit the documentation it takes a few days to show up in their system, they usually have 15 days to approve or deny it.

My surgeon's office just submitted it last week! Found out yesterday when I called UHC that it just showed up in their system and they are working on it! Good luck to you! Have you heard anything yet?

That is AWESOME! Good for you! Now just keep going with it!

I definitely would be, submitted to my insurance today! I may get denied, but I am trying! And I am waiting for Christmas now, lol!

my ticker is from ticker factory, I already had one set up then I saved that page (otherwise you lose it), then it will show the ticker and you can right click and copy and paste it in your signature in your profile.

I found Whey Protein at Walmart, but not sure if lactose free in the powder but I mix it with water!

I was in snug 14s at 195 and fit into 14s well at 185

Honestly that is a loaded question. I am still going through it, we have yet to submit everything to insurance, lacking some records and I've been going through this for a month. Some people it takes 1 month for the whole process, some say it takes 2-3 days once they have submitted and others it takes months. The ones that take months are usually the ones who get denied and appeal. Sorry I can't give you anything specific. I have UHC not Tricare.

Mucle burns calories, so although you may look bulky for a little bit you will burn more calories throughout the day and it will look better long term.

I am in the process of being diagnosed, I have the same problem, Dr.'s thought it was Cushing's Disease or PCOS and I too am considering Lap Band, I have almost all my paperwork together to submit to insured, hoping this week coming up we can send it in! Its very hard to have this kind of disease (and similar ones as I have not yet been diagnosed) and I wish you the best!!!

true, sorry, good advice!

I had a personal trainer back in 2005 that said the best liquor should be clear and you should exercise, like dance or something, or it will turn to sugar. So vodka and diet tonic would be my suggestion. If you like dark liquor then go for Jack and diet. Stay away from beer at all costs!

Thank you sooo much! This is really inspiring for me as I am getting worse health wise, still don't have enough info to submit to insurance just yet, they hope to have all my records by the end of the week! Congrats on the weight loss and keep it up! And even more kudos for the energy and fun with your grandkids!

You can overdose on protein, but it would show up in your urine...

you can always ask to see if you insurance will cover a panni, this is the removal of excess skin, some insurances will pay for it if you doc writes something about bacteria or infections growning under the excess skin. You would have to pay additional for a full tummy tuck and some surgeons will work with you to get as much as they can paid for by the insurance.

Thank you all so very much! Yes I have the moon face and belly, I have the mood swings and thin skin with bruising. All due to one steroid injection, the last time I took Prednisone was in February and only for 3 days cause all the meds I took gave horrible reactions, so all it could be is the ESI. Some docs say that this is impossible, but I'm here to tell them it IS possible. Thanks so much for your kind words and Freelance Frog, your belly will go away, it may be the last to go, but it will! I know that will be the same for me!

All I can say is increase your food intake just a little bit and also increase the exercise. It is about the length of time. My doctor always said you need an hour a day of exercise to lose, 30 minutes to maintain! You are definitely doing great. I have plateaued before last year when I lost 45 lbs on my own and it was hard, it last about 4 weeks, just be patient!

Well in my last blog I told you that I had to lose a significant amount of weight in order to avoid a lumbar fusion. I have been waiting very patiently for my doctor to write my letter of medical necessity to submit to my insurance to see if lap band will even be covered by my plan. And boy, it better be! Now I got a call from my doctors office regarding my physical done for the lap band and I was told to see an endocrinologist now because I now have Cushing's Syndrome. I look hideous, I have a huge hump on the upper part of my back from this overproduction of cortisol and it is all because of the treatment I received for my back. The only way to get rid of my excess tummy, my fat face and this hump is to lose weight! I am praying everyday that my health will be markedly improved and ask for patience as I go through the process of applying for this procedure. I know everyone on this site (mostly everyone) is very positive and caring and I want to thank each and every one of you for your kind words and motivation. I would be such a mess right now if I didn't see the great results and positive feedback. Keep it up and we will all be feeling and looking great!

Completely agree with everything said. And as with most of us, we know how to lose weight, but we need to get our mind focused on it. I have yet to be banded but have lost significant weight on my own and it is not easy. From the wording and "tone" of your post, you truly are a marine. I have many friends who are marines and this is reality. Keep your approach up and all of the attached medical issues due to your weight will get better. That is why I am even considering it. Thank you for the post and congrats on your decision.

I know that I will need one as well after I lose the weight, how did you do it? What did you submit? Any help would be greatly appreciated! Thanks, Kathryn

Wow! Great job!