Jump to content
×
Are you looking for the BariatricPal Store? Go now!

KingsFan

LAP-BAND Patients
  • Content Count

    30
  • Joined

  • Last visited

1 Follower

About KingsFan

  • Rank
    Advanced Member
  • Birthday 05/22/1956
  1. Happy 57th Birthday KingsFan!

  2. Happy 56th Birthday KingsFan!

  3. 3 years has passed since you registered at LapBandTalk! Happy 3rd Anniversary KingsFan!

  4. KingsFan

    hair loss?

    I take Biotin every day and haven't had a hair loss problem (although I am only 2 months post-op). In terms of protein bars, the Odwalla Super Protein bars and the South Beach High Protein bars aren't too bad. I don't like chocolate or peanut butter and the Odwalla bars are more fruity/oat tasting. THe South Beach bars come in lots of different flavors. I like the cinnamon-raisin.
  5. Sorry to hear UHC is treating you so bad. I had a similar experience. I had a BMI below 40 and 2 different UHC reps told me over the phone that as long as I had 2 co-morbidities, I would be covered. I have more than 2 recognized co-morbidities. UHC covered all the pre-surgery procedures. After the doctor agreed to do the surgery, he submitted the pre-approval papers and I was denied. The first explination was that he was an out-of network doctor. Then it was that my BMI was too low. I finally got a look at the coverage documents and my company only authorizes surgery with a BMI of 40 or higher and done by an in-netowtk doc. I appealed, got doctors' letters, etc. but UHC denied. Now my only recourse is to sue my employer for having such an arbitrary requirement. Needless to say that will go over big with my boss. I ended up self paying. My surgey went fine and I am on my way to better health. I was lucky to have the ability to self pay. I hope you have a better outcome with UHC. Good luck.
  6. KingsFan

    Need Opinions

    It depends on your company's requirements. I have UHC Choice Plus and UHC would not approve me because my BMI was "only" 37 even though I have diabetes, high blood pressure and metabolic syndrome. My company's summary plan description limits coverage to those who have had a BMI over 40 for at least 5 years. Don't trust UHC. They told me over the phone TWICE that I would be covered and then turned me down. Get the approval in writing if possible. I ended up self paying and was banded Sept. 12. So far, it seems like a great decision. Good Luck.
  7. Do your vitamins include Biotin? I am a week post-op and my nutritionist told me no Flinstones or other kids chewables because they don't have Biotin and Biotin wil help prevent hair loss. I am using the Centrum liquid which has Biotin. Just a thought. Congrats on the weight loss and let us know what your doctor says.
  8. KingsFan

    United Healthcare Denial?

    I got the denial of my last appeal from UHC. My company's plan specifically limits WLS to those who have a BMI of 40 or over and have had that BMI for at least five years. I had a BMI of 36 but have diabetes, HBP, and metabolic syndrome as co-morbidities. The denial letter said that UHC had no discretion to alter the plan's specific provisions. I was lucky enought to be abe to self pay and I was banded on Sept. 12. If any of you get approved despite specific plan provisions, I would love to hear about it because I am considering a lawsuit and would love to have evidence that UHC did have discretion to cover me. Good luck to all and I can tell you, even though I am only 7 days post-op, that it's worth fighting for.
  9. KingsFan

    Not obese enough???

    United Health Care denied my claim for not being obese enough for long enough. I have three co-morbidities (diabetes, HBP, metabolic syndrome) and they still would not pay. My insurance requires that you have a BMI of 40 for at least 5 years. I have gotten my final denial of my appeal so I am now deciding whether to sue. The denial was based on the specific language of my company's plan and if I sue, I really am suing my company (which won't go over well). I can't imagine a plan provision that says it would treat breast cancer but only after the lump in the breast reached an inch and sat there for a few years. I am in the process of collecting documents and then going to see a lawyer. I went ahead and self-paid and was banded on Sept. 12. I am glad I did it and lucky that I could afford to self pay. But I really feel for those who can't and get denied because appaently the insurance companies are afraid that too many people will want the band. It was a life or death decision for me according to my doctor and it's a major lifestyle change. It's not a diet. It's a medical procedure that addresses serious illnesses and conditions. Sorry to rant but I am looking at thousands in medical costs and a little irritable from not eating. Good Luck!
  10. I was banded on 9/12. I have not been able to drink as much water as recommended. I sip all day but still only manage to get about 32 oz. in. Yesterday I think I drank too much too fast and made myself sick. After making the most monstrous burping noise and having a dry heave, I felt better. I also can't get all the protein shakes in. I am lucky to get through one and a half per day. I am glad to hear I'm not alone. Thanks for sharing.
  11. KingsFan

    Denied... UHC

    I just found out that UHC denied me because my BMI is too low (35). I already had my doctor write a letter and I will send off an urgent appeal tomorrow. My surgery is scheduled for September 12 and UHC said they might treat the appeal as urgent and decide within 72 hours. Good luck to all of us who are at the mercy of insurance companies!
  12. KingsFan

    United Healthcare Denial?

    My doctor's office just called to say that my claim was denied because my BMI is too low. My BMI is 35 and I have type 2 diabetes, high blood pressure and high triglycerides. I was suprised because UHC paid for all the pre-op appointnents and testing. Anyway, my doctor's office recommended I appeal because appeals often are successful. So off I go to appeal land. I'm keeping my fingers crossed.... If the appeal is unsuccessful, I will just have to self pay because my doctor says this is the best chance I have for curing my diabetes and living a long life.
  13. KingsFan

    United Healthcare Denial?

    I work for AT&T in SoCal too. I am scheduled for surgery on Sept. 12 at Cedars Sinai. So far UHC has covered the pre-op tests and the dietician and social worker visits. My doctor's office is confident that they will approve the surgery as well (although they can take a long time). I'll post when I get the insurance approval. Good luck!
  14. I am having my surgery on Sept. 12 and I already have told my family and people at work (so they know why I have all these doctor appointments and why I am taking time off). I don't plan on keeping it a secret. I think telling folks that I had lap band surgery will be a good excuse for why I only order an appetizer when we go out to dinner or why I cannot try one of their home made cookies. People think that offering you food is a way to show they care about you and sometimes people's feelings get hurt when you seem to reject the food. I can just blame the band so that people don't take it personally. But everyone's different about stuff like this. There is no right or wrong answer.
  15. Just got my surgery date. September 12 at Cedars Sinai.

PatchAid Vitamin Patches

×