xgrl

Hey I have BCBS PPO too, if you don't mind me asking what is your BMI? they required me to do the 6 month diet reguardless of my BMI but if you are at 40 BMI or above you don't need to have documented comorbidities well their "approved" comorbidities. Good luck keep us updated

Thanks guys for all your help and well-wishes. I'm so close to the BMI of 40 and I've been 40 before I just actually tried to lose weight on my 6 month diet and now I'm being denied the surgery because I'm below. It's actually really sad that I'm being punished and have to end up punishing my body so I can not go into an insane amount of debt (not to mention to add to my college loans) just so I can get this tool to become healthier. I just made my appt yesterday *because of heartburn being worse* and thought this would be a great opportunity to get the weigh in and send that in with my appeal...that way I don't gotta go back again between classes, reading and work getting into the dr is a hard task thanks again everyone for your support and suggestions

if you go back to more months around the same time you might be able to use the last 4 months make a appt for around a month from your last one just incase they don't accept it that way you can resubmit in 2 months and have 6 consecutive months

I am here to lose weight but if 5lbs is the difference between $2,000 and $20,000 in debt I'm willing to try!

I called BC/BS Alliance Select and was told that I was denied because my BMI wasn't High Enough I've yo-yoed between 37-40 for the past two years and that my co-morbidities aren't enough I have gerd, asthma, migraines, joint pain and depression. Geez I don't know if that is enough i mean my weight basically dictates what I can do in my life. This is so messed up. I'm of course appealling and resubmitting my Insurance lady at the surgeons office is out until Monday so I called and left a message that says I needed to talk to her called my PCP and asked him to write a letter of medical necessity and to please list all the stuff I've tried and failed at, all my co-morbities and how this is going to help me be healthier yadda yadda yadda. Am I missing anything that I should be doing? I'm a college student so self-pay is out of the question. I really think I need this surgery I wouldn't have worked towards this for over a year if it was just gonna be a quick fix I'm ready to start a healthier life for myself why can't my insurance company help me out How much money would they save if I didn't have to go to the doctor as often or get Rx's all the time....:tt2:

ARGH, I got denied again!!!! I'm so upset I just wanna freak out on the insurance people although I know it'll get me know where? something along the lines of ARE YOU FREAKIN KIDDING ME!?!?!? You denied me the first time because you said that my BMI wasn't documented and this time you denied me for "unknown" reasons according to the guy on the phone but apparently it'll be on some letter I'm getting in the mail....prob will say not medically necessary...because that is really specific and helps me try and convince you in the appeals process that I need this surgery! stupid insurance!?!? :thumbup:

okay so I need to vent alittle I was/am watching house and there is this 10 year old girl on there that is obese and the british guy is saying all the normal "reasons" for obesity that obese people just shovel food in their mouths, don't try to exercise, basically that obese people want to be fat and thats why they are.... Seriously it's so irritating I know that most of us have heard these things "slip" from people we've been around (usually shortly followed by the "oh not you") but still its so sterotypical when are people going to learn STEROTYPES are that and just that sterotypes they aren't real and don't apply to every situation. I suppose this irritates me even more because i've heard from a few people lately that I didn't need to have the surgery because I could just watch what I eat and exercise more.... yes because that has worked out so well for me in the past I need a tool to make those things work and without it those things just don't work...okay rant over

I guess I really never watched the show before I just kinda ended up on that channel. It was actually another Dr it's wasn't house himself it was the blonde haired guy dr. the other dr's were trying to tell him that it could be something else (besides the little girl just being lazy as he said) but he just kept refering to her weight as her fault it was actually really sad because I'm sure there are Dr.'s out there that do act like that towards obese children. The one dr said something to the effect of making the little girl feel horrible about herself wasn't going to help the situation. to which the blonde guy dr said that it would if it would get her off the couch. I don't know why it got on my nerves it just did. But I understand more about the show now so it makes sense that they would put that kind of issue on there to make it more interesting. I actually liked Dr. House he's a smart ass but the other dr was just written to be a ass I think. I think i'm gonna watch it more often simply cause I like the House guy not so much the other one....

I should have picked up on that it is a pretty significant difference in accents, oh well I watched the rest of the show and it ended pretty well turns out the girl had cushings but reguardless, maybe they were trying to show how some people can be ignorant to why people are over weight....oh well I'm over it now *that was quick*

She sounds very ignorant as to why we are all in our situation I'm at least 10 pounds heavier than when I started my lapband journey, But once again thats why we are here because we can't do it on our own we yo-yo, seriously i have such a mouth i prob would have said something like "shit happens" but then I'd also get a pretty nasty look from her to. Just blow off what she said, she's not important to you after saturday and you'll prob never see her again if she gives you anymore grief just smile and agree and imagine beating her with a large stick, because obviously she has no people skills. Alright I'm raving now Basically TRY i know it's hard but TRY to ignore negative people and just think someday you'll look back and be able to say "see you were wrong about me!" Good luck at your surgery tomorrow I'll be thinking of you!!!

Thats good to know.... I didn't realize do you know any good tasting ones you can drink everyday I can't find hardly any that don't taste like chalk

I'm pre-op and testing different protein rich drinks and foods. I ran across this and it is soooooo good I don't think I could drink it for every meal because it taste really rich (although its actually really good for you) two words that don't seem like they belong together but this will definatly be a staple in my diet! I found mine at Hy-vee but you can check their website and they will tell you where you can find their drinks at! Just thought I'd pass this along! :party:

Okay This is crazy so I got denied from BC/BS Alliance Select and they sent a letter saying it wasn't medically necessary I called the insurance company to get more details on why I was denied and the girl I talked to told me that my BMI wasn't documented on any of the papers that they recieved....Are you Freaking Kidding Me!?!?!?!?!?! It's on like every paper that was submitted to them on the PCP Papers on the 6 Month Diet Sheets (for EVERY month) and pretty much every other paper they got. I wonder if sometimes they just see people want to get Bariatric Surgery and they are like we'll just deny them.....ARGH so I called my Surgeon and had her circle and Highlight all the BMI's that were on the original sheet of paper that we sent them. This is so frustrating I know there are people out there in the same totally messed up situation. Let me here your F-ed up insurance stories so I won't feel like I'm david fighting goliath! Thanks Everyone!!!

I'm so happy for you both!!!! Good luck with your surgerys I hope everything goes smoothly, I hope to join you soon in the post-op forums!

Hey Ladies! I didn't know it was just gastric bypass at Ames... after I tried working with a dr at Mcfarland that wasn't at all supportive of my decision and didn't wanna help me with my 6th month diet I called the surgery center at Mary Greenly and asked if they knew of any doctors that would be supportive and help me with my 6th month diet I found it in a dr at the Student Health Center. Anyways long story short I'm not waiting on approval after my 2nd submission because insurance company apparently needs a new pair of glasses :thumbup: I hope your surgery went well today keep us up to date that is so exciting! I've heard nothing but Raves for Dr. Glascock, and simply can't wait to have the surgery done. I don't blame you for not telling anyone I told a select few people but apparently I told one WRONG person and she has a really freaking big mouth but used the high school words "don't tell anyone but..." and thinks it's okay to say anything after that :party: needless to say she's not getting any updates! I hear you about people having heart attacks at a very young age some of my parents friend that I thought were way to young to have heart attacks that are pretty healthy people are having them it's just really strange. makes me wonder if there isn't a factor that I'm not seeing but obviously I haven't figured it out yet.... I called my ins. company today and so far they are still "working" on my case....cross your fingers for me ladies! I hope your surgery went off without a hitch and you are recovering well. bambam good luck with your journey keep me up to date! ~Now I have to go Read..... College is so much fun Night Ladies, Xgrl

Hi Everyone I was wondeirng if anyone was from Ames IA I'm going to Dr. Glascock for my surgery so I get to drive Ames to Waterloo for everything but I know it will all be worth it in the end. There is a Bariatric department at Mary Greenley Medical Center (the Ames hospital) But I heard good things about Dr. Glascock. On month Three of the supervised diet plan hoping that I didn't gain anything this month god that would be horrible if it happened again! but it's getting closer to summer and I'm always more active in the warm weather so theirs hope. :smile2:

I feel for ya, they should definatly get on it, I feel like I've never wanted to know something more than if I'm actually approved by the insurance I had to have them resubmit my whole thing AGAIN and this time we Stared and circled the BMI since apparently it wasn't on the last ones *yeah freakin right :cursing: Here's hoping both us hear something soon!!!!!

I couldn't agree with you all any more!!! Insurance is insane but I like the comment about if you don't give up they will eventually cave in that'll keep me nagging them to tell me something I think they are getting tired of me calling them but I feel like if I don't it might never get done! I'm mean seriously Insurance stuff is total crap! I told the lady on the phone that I was between 39-40 BMI during my 6 month diet and she kinda acted like i'd be approved if that was the case hopefully they will OPEN THEIR EYES AND SEE what the paper says this time and I'll get a approval letter....until them I'm waiting I'm still watching what I eat but once again its not really getting me anywhere just like on the 6th month diet I don't think 8lbs is that much in the big picture and at 242 I don't even notice clothes or anything fitting different (not that I expected that) I feel for all of you, sometimes I wish I could just sit down with the insurance people and hand them and point out the stuff that they need to look at it would all seem so much easier. Again thank you all for the support I seriously don't think I could do this without you guys!

I was denied because My BMI wasn't high enough because I lost to much on my 6 month diet I was just at 40 when I started and now from what I understand I have to gain it back so I can qualify for the surgery this seems so counter productive but if history repeats itself without help I'll prob just gain it back over the next few months anyways oh well it'll all be worth it in the end. just seems wrong to have the I have to be healthy person and looking forward to a healthy lifestyle *with some help* and have to gain weight so I can start that healthier lifestyle alright enough with my rant wish me luck :wink2:

Thank you guys so much for being so supportive I plan to appeal it just sucks having to wait for something I've been working on what seems like forever although I know there are people out there that have been fighting the insurance company for alot longer I'm looking into leg weights to get my BMI back up to atleast 40 it sucks that I tried so hard to get my weight down and I'm now trying to get it up so I can get some help to get it down AND STAY OFF lol oh well Thanks so much for your support Hopefully I'll get my date soon!!!

I just wanna look forward to actually thinking I can get a guy and not fast-forwarding to the part where he touchs me or sees me without some article of clothing and is completly turned off....Not that I've even made it that far since I've put on all the weight but my brain takes over and I basically curse myself to failing in any kind of relationship....my shrink tells me I have a phobia of being in social situations because of my weight basically because when I wasn't the size I currently am I wasn't afraid to go out at all, now days it's like I'll get excited till I see myself in the mirror then change my clothes into less fitting and "going out clothes" to clothes like baggie sweatshirts and baggier jeans with flat shoes. GOD I CAN'T WAIT TO FEEL ATTRACTIVE AND SEXY ohhhhh AND to have sex again (it's been a really really really long time)

Hey Supermom, I'm not married and basically have no experiance to base this on but maybe you could try explaining to your husband that this isn't a easy fix by any means we still have to be disciplined and eat less although the band helps us out, people can still out eat it and besides does he know how hard it is to work out when your overweight your joints will kill you for the next few days personally if I do anything beyond walking my knees and hips painfully pop for days. this is your decision hun do it for you maybe he'll relize once you start losing that you are not only healthier but a happier you. I know he's not into stuff that's not his idea but I've read some literature on relationships during and after major weightloss and your relationships do change perhaps you and him should seek counseling. once again i'm not really one to talk but in my head it sounds like sound advice. good luck sweetie and stay strong!!!

For everyone that has to take it out I actually lost my ball on one end and i have no idea how long it was out but it was kinda trick to get back in this sounds kinda gross but lube up the barbell or ring your trying to put in I find it moves smoother that way *and if there are any dirty minds out there think about small hole big gauge of course lube will help* okay that was a little dirty:rolleyes2:

Cindy- Thanks I need all the help I can get I'll do a little extra dance for us tonight hopefully we will get our dates soon!!!! *fingers crossed* :biggrin2:

wow all these storys sound so familer in one way or the other once in high school my grandmother told me that if I ordered some cheesecake for dessert I wasn't gonna fit in my prom dress (which I went to alone) oh and for Prom all my so called friends rented a limo and then told me they didn't have enough room for me in there and went on to say that they were having a much skinner person (they said her name not that she was skinny) ride with them instead. I had a now best friend talk about me to another girl in high school and said that if she was ever that big to shoot her....and now she is if not bigger....my brother called me a 200lb baboon...both of them are freakin skinny :eek:....I get the but your "cute" comment all the time which is just annoying. No one expects me to have a significant other EVER when we go out to bars while all taken girls are trying to find the single girls guys i'm usually left sitting at the table drinking by myself because i'm to freakin self concious to EVER put myself out there.....oh and just last night me my brother and parents were ordering pizzas and we orders a large and a medium and when we were discussing AMOUNGST OURSELVES if that was enough (meaning to bring some home for the next days lunch) the waitress said oh I think that will be more than enough for you guys....ARE YOU F*CKING KIDDING ME! :biggrin: and last but not least Me and a friend who is also a big girl were at mcdonalds and she ordered her meal "large" and the guy taking the order said I should have known. oh oh oh one more when i was younger in high school i had a crush on this guy and i over heard his friends saying "why does it matter you've done a fat girl before" :smile: AND finally the reason we all remember these things in detail is because they freakin hurt I wish skinny people got that whenever guys are assholes to me about my weight I just wanna be like "I heard you have a small d*ck" I mean thats what bothers guys right! Even though that would just bring me down to their level oh and if i go thourgh life never hearing the words "you have such a pretty face" again i will die a happy person this includes when I lose the weight... never again:sneaky: