Westfield27

Sadly I have more medical conditions with my OB/GYN then with my PCP. I suffer from PCOS and recently had a cancer scare do to the endometrium lining being so thick. I've had to get a D&C twice now. Once for a miscarriage that he feels was due to my weight and once because my lining was super thick. He told me if I don't do this it will develop into cancer. He even made me see a GYNO Oncologist which about scared me to death. I am also on Provera to regulate me. I have not had a cycle since March of 2012 when I had my miscarriage.

Yes my surgeon has a team of doctors but they are worried my insurance will ask that I see them for awhile before they can access me and write me a letter of medical necessity. I a praying fingers crossed that me writing basically what it needs to say will push them to actually do it. I've been through this process a few times and have never gotten this far so I am proud of myself for not giving up and I don't plan to. I will do this by any means necessary even if I have to harass people to get what I want.

I have written a sample letter that pertains to me so that it wont be rocket science for my PCP. I have not only sent this letter to my PCP but also my OBGYN so if I receive two letters then that's great as long as I receive one I will be extremely happy.

I'm starting to feel like this surgery is never going to happen for me. I have done everything I need to do on my part but it seems I'm the only one fighting for myself. My insurance has yet to approve my psych evaluation and after calling them directly I found out they've never received anything from my psychologist. My PCP still has not written my letter of medical necessity because "she doesn't know how" after I gave her a sample from my bariatric surgeons office. I called my surgeon who told me himself he would call her personally to make sure it was done and if she still didn't want to do it he'd send me elsewhere. I'm on the verge of a nervous breakdown because I only have six months left before I am no longer under my parent's insurance which covers the surgery and I highly doubt I can afford this good of insurance on my own. Has anyone ever gone through any of this? And how did it turn out?

Thanks everyone for the feedback. I contacted the bariatric coordinator and left a message waiting on her return call. I still cannot believe the nerve of this lady. I will definitely be looking for a new PCP to help me along with this. I am so furious it's not even funny. From what I've seen most of her patients are elderly so who knows what they may have experienced with their WLS everyone is different. It just boggles my mind that she would have the audacity to say that to me.

That's what I was thinking. My OBGYN is very supportive of my decision to do this because of my PCOS and possible ovarian cancer.

So my PCP just called me and told me she cannot write my letter of medical necessity because she has never done a nutrtion plan with me. I am trying to explain to her the letter I gave her was just a sample of what I needed she could take that part out. She then proceeded to tell me all the people she has ever known to get this surgery has failed at it so I'm wasting my time. WHAT KIND OF DOCTOR TELLS THEIR PATIENTS THIS!!!! I am beyond furious right now and have tried calling not only my insurance but also my Bariatric Coordinator to see what I should do about this. Has anyone ever had this happen to them?

Your friend lost weight with Provera? I was told it cause weight gain.

My doctor just prescribed me something called Provera. He said it should regulate me. I take it 15 days out of the month then directly after those 15 days I should get it. I start taking it the 15th of every month so on 15 days off for 15 days.

Sad part is I have not had a TOM since 2012 after I had a miscarriage. I just want to make sure I have the least possibility of being denied as possible. This is the last shot I have and it has me nervous and on edge that one little thing may screw it all up.

My wake up call was about two years ago when I found out that I was pregnant and had a miscarriage. A few months later I found out I have PCOS and was devastated. I want nothing more in life to be a mother and unless I fix my weight problem I will never be able to get pregnant.

I am currently on my last month seeing my nutritionist for the 3 month program required by Aetna for WLS. So far all together I have gained 4lbs over the two months I have been seeing her and have yet to lose any.( I started at 391.6 my last WI was 395.6). I explained to my nutritionist that I was experiencing Water retention thus the reason for my weight gain. I struggle with PCOS which I've learned also makes it hard for me to lose weight. Last week I also found out that I may have ovarian cancer which my GYNO says is due to my size. I am currently 26 and on my parents medical plan which will end for me in 2015 so this is my last shot. If I don't get this surgery this year I will not have the opportunity again. I have seen different stories of people being denied due to gaining weight. Can anyone shed some light on this please? If I lose weight this month will I still be approved although I gained weight the first two months? TIA

True. Mileage does vary, I was just concerned that they would deny me if I hadn't lost any weight better yet gain weight.

Thank You! My surgeon is also hoping for an early July date for me. Everything should be ready to submit by the middle of June.

When I contacted Aetna they never mentioned it but I wanted to be positive since it seems like so many people are required to lose weight before approval.

Yes, I have contacted Aetna and they didn't mention that as part of the approval process. I was really determined myself to do this and lose a few pounds before surgery but it's not happening and it kind of has me discouraged like I'm doing something wrong.

Although I do al lot of forum stalking I've never actually posted but had a question regarding the 3 month program I am required to do by my insurance company (Aetna). So far I have yet to lose and weight and I am in my last month; in fact I've actually gained 5 pounds. I have been having trouble with water retention in my legs and ankles. Although my nutritionist has put me on a lower salt diet I am still not getting rid of the water retention in my legs. I started the program weighing 385 and I currently weigh 390. Will this in any way affect me getting approved for the surgery?