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So disheartened :(

So I started on my Lap band journey back in March. My insurance required a 6 month nutrition program through my work called Intervent. My 6 months was up September 7th. Well my work ended the Intervent program August 31st, one week shy of my 6 months. So my insurance company changed it to a 6 month nutrition counseling program through them. I didn't really think this would be an issue since I had already finished my 6 months. Well apparently it is an issue because I just got a denial letter. They're telling me I have to do their 6 month program to be eligible. I am just sick over this- thinking I would be having surgery in 3 weeks and finding out it may be six months. So sad. Hoping for an appeal I guess. Just had to vent.

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Hang in there... i had to wait 2 years and had to have an obesity law firm file a lawsuit on my behalf. I wouuld suggest that in the meantime you work on getting healthy- and i don't mean trying to lose weight... i mean join a gym, get active, learn about nutrition, and build the support team you will need once you get the band. My band was 1 1/2 years ago and somethings are still a challenge. I recently found the perfect protein shake that you can start now and continue when you get the band. Check out www.myvi.net/katelm Good luck!!

I started November 2009, I was told to do the required exams and I can be booked for surgery. After all the appointments and test were done, in March 2010 I was told I had to do the 6 month program and I was discouraged. I said I'll do it on my own. By Feb 2011 I gained 30 pounds and was ashamed of myself. If I had done it, I'd be a year out and imagine how much weight I would of lost. So I met with my doctor and did all the testing and finally in September I was banded.

My quote is what always gets me through it: Never give up on a dream just because of the length of time it will take to accomplish it. The time will pass anyway.

Agree - Hang in there. My insurance company did the same thing. I ended up calling them every day and wanting my case reviewed...talked to supervisors. It was a very stressful time, but after requesting a review, the insurance company approved me. I never had to change the date and was banded Monday. This was one of the most frustrating times. Also, check your insurance to see if it says 6 months consecutive or just 6 months. I know of another bandster who did not have 6 months straight and was approved.

Yes, I agree with everyone here. Hound your insurnace company as much as it takes. I warn you tho that sometimes you still get the shaft. I hounded mine, and they approved my six month plan that I already did, but then they added stipulations to the bargain. This is why I ended up being self-pay. I was afraid they would keep adding stipulations as I met them that it would have made it impossible.

What I don't understand is how health insurance companies can be the way they are about WLS, but they don't mind paying for all the co-morbity costs associated with obesity- and not make people complete "programs" for that.

  • 5 weeks later...
  • Author

Thanks for all the support! Got it all worked out and had my surgery on the 17th!!

Dana, if you have time, maybe you could describe the steps you went through

to get approval. It's not for anyone in this thread, but to help people who haven't

even started yet. It's surprising how many folks have similar problems and

this type of information is invaluable to them. TIA

  • Author

I really didn't do anything, the insurance coordinator at the surgeons office called my insurance company. Those people have a lot more pull than I do!

Hang in there... i had to wait 2 years and had to have an obesity law firm file a lawsuit on my behalf. I wouuld suggest that in the meantime you work on getting healthy- and i don't mean trying to lose weight... i mean join a gym, get active, learn about nutrition, and build the support team you will need once you get the band. My band was 1 1/2 years ago and somethings are still a challenge. I recently found the perfect Protein shake that you can start now and continue when you get the band. Check out www.myvi.net/katelm Good luck!!

SPAM.....there are enough ads on the sides of the screen....we don't need them IN the posts.....

S.

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