Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Horribly disappointed



Recommended Posts

I am so horribly disappointed right now. I cried all the way home from an informational seminar for the doctor I want to use -- a 45 minute drive.

Seminar was fine, I didn't have questions that could be answered right then (mostly for the nutritionist, etc. rather than the doctor as I've been researching this and reading all your stories, advice, good times, bad times), but afterwards the gal that handles some of the insurance tells me that UHC will require 6 months of supervised dieting or 3 months if I have a supervised diet, pay for an exercise person, and something else I can't remember because I was in shock. UHC never mentioned the supervised diet to me when I called them to find out whether I was covered and what I needed to qualify. My BMI is 47.whatever the ticker says, and I have sleep apnea and severe hypertension. Perfect candidate for weight loss surgery!!!! The doctor even quoted statistics that people 100 lbs. or more overweight are not successful with diet and exercise alone with keeping it off (don't yell -- I know there will always be exceptions to that, but in general...).

I've been so excited about the whole banding thing and finally being able to get the full feeling sooner so I can stick to the life food change (ie diet). This was a huge blow to me and now I have to try to not let myself sink into a bad depression.

I was a chunky kid and somewhere between 18-20 years old my weight took off, quickly ballooning up. I'm 46 and have been morbidly obese for the last 20 years. I've tried diets, feel like I'm starving and then fall off the wagon once I hit a plateau that goes on and on (4 months was the longest I waited out a plateau before giving up). Since I've been on a new BP med that is finally keeping the blood pressure down from stroke level I've gained 10 pounds -- my fault with, I truly believe, an assist from the meds. I'm not going to be on this supervised diet and suddenly get a different result. When I did Weight Watchers -- that was supervised and I lost weight, felt miserably hungry all the time and then hit the 4 month plateau). I'll do it because I'm desperate for the help the band can offer as I work to eat right and exercise.

Now I can add to my worry that by open enrollment time at work they'll change the insurance and banding won't be covered. Plus the fact that I've way more than met my deductible of $800 for the year already with tests I've had done to make sure I wasn't having any major heart issues, plus the new CPAP to replace the one that was quickly dying. Which also meant I was closer to my maximum out of pocket for the year and would have been able to save money on the 20% I have to pay for the surgery. Then there is the fact that my primary care does not have office hours conducive to those of us who work from 8am to 5pm Monday through Friday -- any guess as to what her office hours are??? So now I have to take sick time and vacation to go see her for the supervised diet, plus pay the office visit copay, etc.

I'm trying to figure out where the heck I'm going to come up with the money for all of that.

If anyone is still reading... sorry, just needed to vent and see if I could stop crying.

I know that if this surgery is what I'm supposed to have then it will work out somehow but I feel like somebody sucker punched me right now.

Thanks for listening. Sorry for any typos, etc.

Hugs to all.

Share this post


Link to post
Share on other sites

*hugs* I am waiting on approval for surgery as well and I needed to do 3 months of supervised dieting. Then after that I have to wait even LONGER for approval. Right now I am just continuing with the supervised diet so I can get in six months worth JUST IN CASE I get denied the first time around.

Make sure you ask your PCP office if you can just come once monthly in the early AM to be weighed and to leave your paper work to be filled out. I found out AFTER I payed a bunch of copays that I have that option. It just takes fifteen minutes at the most out of your day and they fax your papers in to the surgeons office for you.

I hope this helps a little! Just keep positive!! It's a journey to reach the surgery, take the time now to find out as much as possible about the surgery and post op nutrition on this site. *super hugs*

Share this post


Link to post
Share on other sites

What you are going through is perfectly normal. The ins company just wants to make sure you are serious about this journey. It could be worse......you could have to pay for it yourself like I did & many others have.

Share this post


Link to post
Share on other sites

I sympathize with you. I also understand the initial shock, disappointment and worry. I too have UHC and I did not have to do a supervised diet at all. My BMI at the time of surgery was something like 43 I think. I did have to fill out a packet from the surgeon that included a 5 yr weight history (to show that I didn't gain weight all of a sudden) and I had to list all health issues that are weight related. The last thing on the form was to list all of the diets I had tried, how long I had stuck with them and how successful I had been on each one. I had absolutely no problem getting approved. Maybe you can ask your surgeon if they have a form like that. Best of luck to you!

Share this post


Link to post
Share on other sites

I know how u feel. I started my preop testing last June 2010.. The paperwork was finally submitted to BCBS Federal in December, but BCBS did not reply back until Jan 2011..which by then they had changed the rules..I also had to do 6 more months of supervised diet and excercise by my doctor..Disappointing!! I finally had my surgery on June 27. Hang in there, it will happen, just not the way we want it to! It is worth every thing I went through! :)

If you have any questions, please contact me!

Share this post


Link to post
Share on other sites

Hey I am in the same boat as far as the hypertensio goes.... My #s are all over the place, the highest I have ever checked was 185/114 last week. Today it was 163/98! I am taking meds too but I hate the way they make me feel. What are your numbers like? Also prediabetic

(stage2) wouldnt it be nice to get off these meds with this Lap Band surgery.

Share this post


Link to post
Share on other sites

*hugs* I am waiting on approval for surgery as well and I needed to do 3 months of supervised dieting. Then after that I have to wait even LONGER for approval. Right now I am just continuing with the supervised diet so I can get in six months worth JUST IN CASE I get denied the first time around.

Make sure you ask your PCP office if you can just come once monthly in the early AM to be weighed and to leave your paper work to be filled out. I found out AFTER I payed a bunch of copays that I have that option. It just takes fifteen minutes at the most out of your day and they fax your papers in to the surgeons office for you.

I hope this helps a little! Just keep positive!! It's a journey to reach the surgery, take the time now to find out as much as possible about the surgery and post op nutrition on this site. *super hugs*

I've been "haunting" the boards for about a week now. At night when I'm home from work and during lunch at work. And sometimes if I'm waiting for the computer to catch up at work I'll hop on via my phone until my computer is ready to let me do my next work task. I love this site as I can get information directly from people who have been through the process. Not that the doctor sugar-coated anything tonight during the seminar, but after all it is his entire business. I wanted to read about everything no matter how bad. If you have as much information as possible, it helps you make an informed decision. I even ordered a sampler package of the powders?utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury Protein powder, got it yesterday and tried the chocolate supreme. OMG, yummy!!!! Very chocolatey. Only slight aftertaste for me about 15 minutes after I finished the last sip - went to the restroom at work and did a quick brush and was fine.

Share this post


Link to post
Share on other sites

Hey I am in the same boat as far as the hypertensio goes.... My #s are all over the place, the highest I have ever checked was 185/114 last week. Today it was 163/98! I am taking meds too but I hate the way they make me feel. What are your numbers like? Also prediabetic

(stage2) wouldnt it be nice to get off these meds with this Lap Band surgery.

I was usually running a low of 140 to a high of 170 on the upper and 85 to 95 on the lower on meds. The new meds have brought it more in line with 140-155 and 80-85. Obviously still not great, but after having them so high for so long even on meds and watching salt and attempting to lose weight -- I'm grateful. Plus the Diovan HCT does not cause the horrible cough or the ankles swelled so big that I could hardly walk that the others BP meds did. It was awful. I know that if I can take off some weight that the numbers will come down more. I have family history on both maternal and paternal sides of hypertension so I don't know if I can get rid of it completely, but maybe yes? hopefully?

I don't remember my very highest number (bottom was over 100 don't remember the top at all). I do know that during a stress test I had done in June at a cardiologists (checking for blockages-no visible ones yippee) that when I was on the treadmill it soared. My resting rate was 134/84 and then about 7 minutes in when they kicked it to the 3rd level it shot up to 218/76. They also had to make me lay down for a bit after I got off because my BP wasn't coming down. Funny thing is other than it being very difficult to catch my breath and I was sweating like a pig (do pigs sweat?), I didn't feel like I was having a BP issue -- no headache or double vision, nausea, etc. This reaction to the treadmill test may explain why I feel so much like crap when I push myself during exercise. I'll just have to take it slower and work my way into it. Any exercise is better than sitting on my butt.

Share this post


Link to post
Share on other sites

What you are going through is perfectly normal. The ins company just wants to make sure you are serious about this journey. It could be worse......you could have to pay for it yourself like I did & many others have.

I'm glad I have (at least this year, who knows about next) insurance coverage. I actually started seeing things about Lapband 2 to 2-1/2 years ago but had no insurance. Was deeply in debt with no job after being laid off. Still working on paying down those balances. So I didn't look into it seriously because I could never have afforded even to make payments on a plan on my own. Getting the insurance last year was a blessing. My CPAP was on it's last legs and I didn't want to go back to being so tired I could drive all the way to work and not know how I got there -- I'm lucky I never hurt or killed someone. I was ready to have my father drive me to and from work (he was retired).

I'm happy that some of you without insurance (or their insurance wouldn't cover) were able to come up with the money to get the surgery. I wish everyone who has struggled over the year's had the opportunity to make the choice and not have to worry about going bankrupt trying to get healthy.

Share this post


Link to post
Share on other sites

Call your insurance and ask them. I can feel your pain though. I had a surgery date, had lost my 10% body weight (33 pounds) and had to postpone my surgery because a blood clot that I was being treated for was not completely resolved. Soooo it ended up taking me 8.5 months from consult to surgery. However in that time I ended up loosing 50 pounds and developing a new relationship with food. Personally I think changing how you think of food is a fundamental part of being succesful with the band. It will never stop you from eating Ice cream every day or having chocolate bars. Use this time to get your head in the game.

Share this post


Link to post
Share on other sites

All or mostly all insurances require six months of supervised visits I do not know of any that dont. However six months goes by fast. Just think how we were just celebrating the new year and its August already. Start now and the new year will be a new you

Share this post


Link to post
Share on other sites

I am so horribly disappointed right now. I cried all the way home from an informational seminar for the doctor I want to use -- a 45 minute drive.

Seminar was fine, I didn't have questions that could be answered right then (mostly for the nutritionist, etc. rather than the doctor as I've been researching this and reading all your stories, advice, good times, bad times), but afterwards the gal that handles some of the insurance tells me that UHC will require 6 months of supervised dieting or 3 months if I have a supervised diet, pay for an exercise person, and something else I can't remember because I was in shock. UHC never mentioned the supervised diet to me when I called them to find out whether I was covered and what I needed to qualify. My BMI is 47.whatever the ticker says, and I have sleep apnea and severe hypertension. Perfect candidate for weight loss surgery!!!! The doctor even quoted statistics that people 100 lbs. or more overweight are not successful with diet and exercise alone with keeping it off (don't yell -- I know there will always be exceptions to that, but in general...).

I've been so excited about the whole banding thing and finally being able to get the full feeling sooner so I can stick to the life food change (ie diet). This was a huge blow to me and now I have to try to not let myself sink into a bad depression.

I was a chunky kid and somewhere between 18-20 years old my weight took off, quickly ballooning up. I'm 46 and have been morbidly obese for the last 20 years. I've tried diets, feel like I'm starving and then fall off the wagon once I hit a plateau that goes on and on (4 months was the longest I waited out a plateau before giving up). Since I've been on a new BP med that is finally keeping the blood pressure down from stroke level I've gained 10 pounds -- my fault with, I truly believe, an assist from the meds. I'm not going to be on this supervised diet and suddenly get a different result. When I did Weight Watchers -- that was supervised and I lost weight, felt miserably hungry all the time and then hit the 4 month plateau). I'll do it because I'm desperate for the help the band can offer as I work to eat right and exercise.

Now I can add to my worry that by open enrollment time at work they'll change the insurance and banding won't be covered. Plus the fact that I've way more than met my deductible of $800 for the year already with tests I've had done to make sure I wasn't having any major heart issues, plus the new CPAP to replace the one that was quickly dying. Which also meant I was closer to my maximum out of pocket for the year and would have been able to save money on the 20% I have to pay for the surgery. Then there is the fact that my primary care does not have office hours conducive to those of us who work from 8am to 5pm Monday through Friday -- any guess as to what her office hours are??? So now I have to take sick time and vacation to go see her for the supervised diet, plus pay the office visit copay, etc.

I'm trying to figure out where the heck I'm going to come up with the money for all of that.

If anyone is still reading... sorry, just needed to vent and see if I could stop crying.

I know that if this surgery is what I'm supposed to have then it will work out somehow but I feel like somebody sucker punched me right now.

Thanks for listening. Sorry for any typos, etc.

Hugs to all.

Hi there. I didn't read your entire post. Just the bit about your UHC insuarance and their requirements. I have UHC and I did not have to go through a supervised diet for 6 months or do an excercise program. I went through True Results and within 2 weeks of starting everything I was approved to have the lap band surgery and did so 7/26/11. Call your insurance company yourself and ask questions. Good luck to you!

Share this post


Link to post
Share on other sites

UHC caters their policies to the companies that buy them so each policies requirements might be different. I have UHC and it isn't even covered, it's a direct exclusion at the request of my company and they are not going to budge so while 6 months probably sounds like a long time, imagine paying anywhere from $13,000 to $20,000 out of pocket like folks like me. I would be glad if it was covered at all. Your situation could be much worse.

Share this post


Link to post
Share on other sites

I understand exactly how you feel. I went to the seminar class 3 weeks ago and finally called to find out when I could see the doctor for my consult. They said they were booked up until September 7th so I am again waiting. What is frustrating is I have already did all the leg work for the insurance (UHC), got my approval numbers, letters, letter from my primary physician, etc. I am way ahead of the game but waiting all the same. Even my primary doctor does not get the supervised diet stuff but is willing to go along with it if we have to. He said, I gave you a letter of refferal/recommendation (you also have to get), what else could they want... But I will do whatever they say do. I am looking at Feb. 2012 for my actual surgery because of all of the hoops you have to go thru. Oh yeah, I have already met my out of pocket for this year so it is very frustrating to be pushed to Feb. Hang in there, we will make it.

Cindy

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Kanika katyal

      A Deep Dive into Modern Coffee Brewing: Siphon, Pour-Over and Automatic Brewers
       The rise of the automatic coffee brewer has added another dimension to this brewing renaissance. As more enthusiasts seek the perfect coffee brewer online in India, understanding these methods becomes paramount.
      Read more: https://kitchenappliancesestore.weebly.com/blog/a-deep-dive-into-modern-coffee-brewing-siphon-pour-over-and-automatic-brewers

      · 0 replies
      1. This update has no replies.
    • NickelChip

      I'm checked into the hotel near the hospital and just had my last protein shake of the day. My mom has kindly gone down to the restaurant alone so as not to make me die from watching her eat dinner. Checking in at the hospital tomorrow at 10:50am. So ready!
      · 1 reply
      1. BeanitoDiego

        Pulling for ya!

    • Clueless_girl

      6 wks post surgery, had to go back to the hospital to replenish potassium levels. STILL struggling with abdominal pain and nausea. Any suggestions would be appreciated!!
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Six months pots-op as of yesterday. I celebrated with a HIIT class where I was challenged to do a wall-assisted handstand. I truly thought there's no way in hell that I can get up there. Well... I proved myself wrong. The instructor said, "Just try getting one foot up there." I tried and it was so easy, that the other foot went up, and the next thing that I knew, I was standing on my hands with my legs up in the air, leaning against the wall.
      Last weekend I challenged myself to a 10-mile hike, and I was SURE that my legs would be non-functional that night and the next day. But that didn't happen at all.  But I did learn that I need a new hiking boot or shoe. I've got a goal of walking the Portuguese coastal route of the El Camino later this year, and I good shoes will be essential.
      I've hit another weight loss stall, but that's to be expected. I am so close to my goal already that if it does take 6 more months to get that last stone off, that's okay with me. And I am building muscle, so that stone may never move. S'alright friends, s'alright.
      · 1 reply
      1. Bypass2Freedom

        Congratulations! I bet that felt awesome to achieve! 😄

    • South Coast Deli

      South Coast Deli brings a superhero flair to fast, casual dining with three locations across Santa Barbara. Dive into a diverse menu featuring breakfast sandwiches, bagels, hearty salads, and a variety of sandwiches, including vegan and vegetarian options. Whether you're craving a classic deli experience or a warm panini, this deli satisfies with quick service and a playful atmosphere. Perfect for on-the-go meals or a leisurely bite, South Coast Deli is your go-to for fresh, delicious fare with a comic book twist.
       
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×