Mz. NuNu

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I talked with BCBS and was told the same thing. I'm just at a loss all the way around. My policy requires 3 years of medical records to be submitted. Because I have a single BMI less than 35 back in 2013, the insurance coordinator at what I thought would be my surgeon said that even I satisfied all of the other requirements, I would be denied for coverage of the surgery because of the "low" BMI. So I feel like my journey is over before it even began.
I am disappointed in that the insurance person doesn't even acknowledge that yes, denials can happen, but that is not always the final answer. I feel like a valid case could be made for approval since all my other BMIs (back to 2008) are above 35 and I have comorbidities. I don't know if they just choose not to advocate for their clients because they offer (and push) a cash payment option. If I was a betting person, I would think they make more off cash payments than insurance.
I don't want to totally give up, but cash paying isn't an option for me. At this point, even if I did have the money, I think I would find a different surgeon. I am sorry this is somewhat long and a diversion from my original post...I was/am so frustrated with the whole process I have just thrown my hands up in the air.

I did 6 months starting in June in preparation for this, so my PCP provided me with those notes for the Bariatric hospital and UHC. I also had a sleep study over the summer and was diagnosed with sleep apnea, and now use a cpap, which is a co morbidity, and will help me be approved. I have my 1st consult with UHC case manager, and my 1st surgeons appt on 1/26!! I;m on a roll!!

Tomorrow is the 2nd! I am considered "insured"! I"m calling them tomorrow to enroll in the bariatric program, then calling my Bariatric team to set up my 3 appts I need to complete before approval. YIPPEE!! I'm ready to do this thang!!!

My first attempt at approval was a long, disappointing headache. We submitted to BCBS and they denied it saying I didn't have a co morbid when their criteria clearly stated BMI of 40 and greater or 35 and a co morbid. At the time mine was around 50. We appealed and proved our case but they then admitted I was a candidate but denied it due to administrative error. There were no errors. The next option was a state fair hearing which we pursued to get the run around. By this time it was open enrollment so I switched to WellCare. During all of this I finished the 6 month diet because BCBS only required 3. My insurance started the 1st of January. My doctors office submitted my packet on the 5th. Yesterday! This morning we got the approval. I am beside myself right now. I go in Thursday to get a date!

This all makes me nervous! I am waiting on approval from Cigna right now. They told me they have 30 days to let me know. So nerve wrecking!

Sorry folks. Was back in hospital a week. Just got out again. They inserted an NG tube so I am being tube fed 24/7. Guess from my nose to my small bowel. They are hoping it wakes things up. I am finally able to tolerate some liquids in my own. If all goes well, they may pull tube in a couple weeks and I will be on my own and hopefully sustaining myself. We shall see. Been living this nightmare for 2 months now. 4 hospital stays 5 ER trips, 1 ambulance trip. Ugh

Hi there! I'm new to the list and recently decided that the sleeve was the best option for me. My BMI is around 34, but I have other factors (heart attack at age 34 and continued high cholesterol & blood pressure). I was approved for the sleeve gastronomy but my insurance will not pay at all (I have Blue Cross).

I'm really trying to psych myself up for the negative feelings of the first few days. Even though I know you are feeling bad, you are post-op and I would do almost anything to be in your shoes right now.

Went to my 5th supervised appointment today. I was told to maintain my weight for my last appointment on 1/29/15. Then they will turn in all my stuff to the insurance cuz I've had all my blood work and other things done so they are In the system already. Then after approval I come in for a preop class and then meet the surgeon for the date. Cross ur fingers for me.

I'm from Louisiana. I choose Dr Yanez because he does both the gastric sleeve and the cosmetic surgery procedures. He has been featured in numerous well known magazines and is very good at what he does from everything I've read. I am a little afraid to travel to Mexico but it half the price then wh err re I'm at here is $11,500 dollars. I'm self pay and my BMI is only 33 I'm 6ft 2inches tall and they wouldn't approve me here.

I hear you. I think a lot of people eat badly and put on 10 lbs, then go back to "normal" and lose it and assume that it's the same thing for everyone. The reality is that obesity is nothing like an extra 10 or 20 lbs and that working hard at the gym, or eating healthfully, or any number of things just isn't enough. If it were, most of us wouldn't be here! Just nod and smile and ignore the naysayers--they don't have to live in your skin.
Good luck today! I'll be there in just over 2 weeks...

Good luck tomorrow and remember that many people do not have all the facts when they judge our decisions. Believe in yourself and in your doctor....you are going to be fine. And dont forget to continue breathing!

Good Luck tomorrow! My surgery is scheduled for tomorrow too! I go in @ 1:00pm!

Good Luck tomorrow!! It's hard not to be nervous, But you will do great!!
All I took with me was my phone and some real good lip balm. That's it!! I really needed the lip balm and was so thankful I had it. I used an extra gown to throw over my shoulders like a robe when I did my walking, which I very soon after being in my room and every couple hours after that. Grant it the first few times I didn't go to far but by the third time I was all the way around the floor. I also didn't need slippers or anything because the hospital puts on slipper socks, green, yellow or red depending on how you are allowed to get out of bed. I had green so I was good to go, and they have non slip on the bottom.
I am a big baby on pain so I was hitting my pain button every time it turned green. I really don't remember any pain, but just a little discomfort getting up and down out of bed. I slept on my side on that first night too. Hubby said it was because I was so drugged up. LOL I came home by dinner time the next day and never touched any of my pain meds at home. I couldn't believe it, cause when I say I am a baby I MEAN I am a BABY!! LOL
Oh the other thing I took was my stomach stuffie my daughter and hubby had got for me before surgery. It was a nice comfort and a great conversation piece every time someone came in my room to check on me.
Let us know how it goes when you are able to!! Good luck on your journey!! Here's to a new you !!!

You are gonna do great! This will transform your life. I had the sleeve on 12-23. Was scared and unsure. Everything went fine. Congratulations: this is the start of a whole new you!

@@time for june You're welcome, I'm a little over 8 weeks and everything is good! I have no appetite at all so I have to remind myself to eat, my surgeon wants me to up my calories from 700 to 1100. Not sure how that will happen but I'm working on it. It a odd feeling to be told to eat more that's for sure

Add me to the List of the 30th Sleevers. Thank goodness I only have 5 days of Pre-Op liquids, and am working on Day 4. shakes, broth, Jello and Water; I am sick of them all. I feel weak, tired, and on a short fuse.

Good Luck I will be joining you tomorrow too!!

Wow! Best of luck! I had mine last tuesday, Dec 23rd. Best thing I ever did for myself!

I can't believe tomorrow is the day I've been waiting for so long!!! I'm super nervous but happy at the same time
I'll be updating when i can

Saying prayers for you. Hope you are soon out of the woods with all this soon and feeling better. I am so sorry you've been going thru so much hell. I know you are worried about your insurance coverage but I think it's time for your wife and you to start making a fuss and getting the care you need to get well. It isn't supposed to be like this. Keeping you in prayer!

@@VGB I've lost 13 lbs in 6 days.

Day 2=postop. Still feel good, zero nausea/voniting, soreness stung in, but managed with med. Only problem is I am peeing like arussian race horse, and can't get unplugged quick enough, have had a few accidents..lol

Prayers for a safe & speedy surgery & recovery. Think about how sexy you are going to look afterwards. You will be just fine....hugssssss