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MsK1972

Gastric Sleeve Patients
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Everything posted by MsK1972

  1. My BMI was 35.3 when I got started on this journey in January 2013 and Aetna denied me stating that I needed to be Obese for at least 2 years before they would even consider it, I have only been considered over weight for about 1 year because I had 2 knee surgeries and back issues after a bad accident...so I packed on the pounds being less active.... I have sleep apnea, high blood pressure and hyper tension. I was very upset and left that surgeon because they let me get all the way up to a week out from surgery to tell me I was denied and that they were sorry this was a new requirement of Aetna ...this was a lie the coordinator was just careless. I switched surgeons, and hospitals and got Priority Partners Insurance and, Allof my records were transferred so I didn't have to start over from scratch but this surgeon had a few more requirements which I was good with...because my BMI was just at the threshhold I was only asked to lose about 5 lbs but lost 7lbs...they submitted to insurance but I was denied because they said I wasn't serious about losing weight...that was in July..then my doctor resended my application and we worked on weight loss for anothr few weeks and I lost about 4 more lbs for a total of 11 lbs. We then resubmitted and I was denied again..guess why? Because my BMI was too low...SMH. I was so upset because THE INSURANCE is the one who said I needed to lose the weight to begin with. My doctor did a peer to peer and submitted my food diary and I just got apporved Thursday September 5th. I will get my surgery date on Monday. I am so excited. I started to feel like it just wasn't meant to be. Keep your head up it will turn around..insurance companies just don't like to pay for surgery....period. and this to them is elective, I said all that to say..it's a toss up, It also depends on what your insurance requirements are..I did what seemed like a million tests prior to submission but you really want ALL of your ducks in a row (tests, requirements, letters) in order before they submit because in some cases you cannot appeal..it depends on the reason for denial...so don't rush it as long as you end up with getting an approval.
  2. MsK1972

    This is why im doing it

    Yes girl!!! Me too...me and food have a love hate relationship. BTW your friend is a HATER, why else would she do that? I would have killed her right there and would have had to lose weight in jail...Lol! I haven't shared my surgery with anyone but my best friend and my daughter so for an entire room full if ppl to hear it from a so called friend would have just horrified me. You are going to be beautiful..and maybe just maybe you should keep more supportive ppl around you. XOXO
  3. MsK1972

    BMI 35 and insurance approved? ?

    That's great to hear you lost 60 Lbs in less than 4 months...awesome!! I can only pray I'm that fortunate..it's crazy you wanna lose it and then you worry what if I lose too much? I met a woman who has GP and she looked very unhealthy and old...and she was young. She was 400 lbs to start though but still she said she had lost so much weight at first she looked scary...said she was happy she gained some back..but to me she still looked ILL so I dunno I just gotta stop comparing..
  4. MsK1972

    BMI 35 and insurance approved? ?

    Thanks...yes some insurances really give you the business but I finally got over the hump. I'm really excited..more worried about failure..I'm reading stories about ppl not losing when they don't have 100 or more lbs to lose..
  5. MsK1972

    BMI 35 and insurance approved? ?

    My BMI was 35.3 when I got started on this journey in January 2013 and Aetna denied me stating that I needed to be Obese for at least 2 years before they would even consider it, I have only been considered over weight for about 1 year because I had 2 knee surgeries and back issues after a bad accident...so I packed on the pounds being less active.... I have sleep apnea, high blood pressure and hyper tension. I was very upset and left that surgeon because they let me get all the way up to a week out from surgery to tell me I was denied and that they were sorry this was a new requirement of Aetna ...this was a lie the coordinator was just careless. I switched surgeons, and hospitals and got Priority Partners Insurance and, Allof my records were transferred so I didn't have to start over from scratch but this surgeon had a few more requirements which I was good with...because my BMI was just at the threshhold I was only asked to lose about 5 lbs but lost 7lbs...they submitted to insurance but I was denied because they said I wasn't serious about losing weight...that was in July..then my doctor resended my application and we worked on weight loss for anothr few weeks and I lost about 4 more lbs for a total of 11 lbs. We then resubmitted and I was denied again..guess why? Because my BMI was too low...SMH. I was so upset because THE INSURANCE is the one who said I needed to lose the weight to begin with. My doctor did a peer to peer and submitted my food diary and I just got apporved Thursday September 5th. I will get my surgery date on Monday. I am so excited. I started ti feel like it just wasn't meant to be. Keep your head up it will turn around..insurance companies just don't like to pay for surgery....period. and this to them is elective,
  6. MsK1972

    10 1/2 months post op

    I just want to tell you that you look awesome....I am due to have surgry this month. My goal is to lose 55 Lbs, I could do it myself if I could run or even walk fast but I had 2 kne surgeries and I need a knee replacement...so that is out the door...I am excited though because I have gone through a lot to get to this point and get approved for surgery.... and I am however worried about what I will look like..flabby etc. You look great. I know you said you had a tumm tuck but your arms look great too...did you find that any other areas were flabby after you lost so much weight?

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