erinm51

Almost 5 months out, and I finally hit that 75 lb mark. Took some pics to celebrate!

@@erinm51 Denying you when you meet the criteria set by the insurance company is, in my opinion, discrimination. Please don't tolerate it. And, if you do get denied, make sure you appeal!

Wow, I can't believe they turned you down. My friend went through the same thing. They want you to
give up. This is your health and you want to live a long, healthy life. Drive them crazy and you
will get your surgery. Send them so much paperwork they will be happy to get rid of you. Have a good
day and keep us posted.

I was turned down twice even though I have sleep apnea and back and foot problems. I fought it, and papers after papers they wanted from different doctors. I was so angry because my struggle with weight was ongoing for over 14 years. I did program after program and went up and down like a yo-yo. The clinic I worked with was very helpful and put together a convincing proposal of how medically necessary it was and after 7 months finally got the approval. My main problem was my BMI being too low but they wanted to be blind to the declining health conditions. Don't give up, there must be something you havent thought of, make a list of all the health conditions you have due to your weight, and all the different things in the past that you have done on your own and try again. Good Luck

Forgive me if I rant, but this stuff drives me crazy. Obesity is a disease. Nobody disputes that. However, when seeking treatment, you have to jump through hoops and it makes me nuts!
Keep at it and good luck to you!

erinm51: I think it is hard to get the surgery if you don't have a high BMI. My friend at work was
turned down because of that. I had records from the pain clinic, my Doctor, the hospital from all
of the surgeries. I had high blood pressure and was on tons of pain pills. I was spending a
fortune just to be able to walk. Do you have medical issues caused by your obesity? I live in
Florida as well and they are very strict about approving weight loss surgeries, especially BCBS.
It is like pulling teeth. I went to the first seminar in September and had my surgery on December
10, 2014. I don't know if you are as determined as I am but when I made the decision to have the surgery I didn't stop. I called BCBS every day, I would not stop. Your surgeon could really boost
your chances by writing a letter to the Ins. company describing the complications you are having
due to your weight. Don't give up, keep pushing. If this is what you want don't let anyone get in
your way. Take it to the mattresses. Fight, fight, fight. Good luck

Here is a list of obesity co-morbidities the http:/www.nih.gov the government website for The National Institue of Health. Claim as many as you can. For most of us, that is more than a few.
Obesity Comorbidities
To follow is a list of comorbidities (additional conditions or diseases) related to obesity which may help you in qualifying for weight loss surgery.
• Family history of heart disease
• Family history of stroke
• Family history of diabetes
• Family history of heart attacks
• Hyperinsulinemia
• Diabetes
• High blood pressure
• Coronary-artery disease
• Hypertension
• Migraines or headaches directly related to obesity or cranial hypertension
• Congestive heart failure
• Neoplasia
• Dyslipidemia
• Anemia
• Gallbladder disease
• Osteoarthritis
• Degenerative arthritis
• Degenerative disc
• Degenerative joint disease
• Recommended joint replacement from specialist
• Accelerated degenerative joint disease
• Asthma
• Repeated pneumonia
• Repeated pleurisy
• Repeated bronchitis
• Lung restriction
• Gastroesophageal reflex (GERD)
• Excess facial & body hair (Hirsutism)
• Rashes
• Chronic skin infections
• Excess sweating
• Frequent yeast infections
• Urinary stress incontinence
• Menstrual irregularity
• Hormonal abnormalities
• Polycystic ovaries
• Infertility
• Carcinoma (breast, colon, uterine cancer)
• sleep apnea
• Pseudotumor cerebri
• Depression
• Psychological/sexual dysfunction
• Social discrimination
• Premature death in the immediate family

Thank you for advice, I contacted my insurance as sugested but they really did not give me any further info other than the lap band is a covered under my plan. They told me that they will give further info to my provider and they will discuss with me. The orientation I was going to was cancelled so I will be going to a one on one orientation next week instead. I hope to get a lot more info from them.
Thanks again for all the help

Thank you for advice, I contacted my insurance as sugested but they really did not give me any further info other than the lap band is a covered under my plan. They told me that they will give further info to my provider and they will discuss with me. The orientation I was going to was cancelled so I will be going to a one on one orientation next week instead. I hope to get a lot more info from them.
Thanks again for all the help

Hello and thank you for all the replies and info. I have my orientation on Jan 3rd
in the Tampa area. I hope I will find out then what my insurance will require, I think my bmi is 39 so I might have to meet different requirements than if it was 40 or more via my insurance documents but who knows?
Merry Christmas everyone and thanks for all the help