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

Bad Comment From Insurance Company..



Recommended Posts

So.. I had my pre op appointment today.. I have to lose ten more pounds before my insurance will approve it.. Talk about lighting a fire under my butt lol.. But I was pretty offended to find out my insurance company said.. "she's still young.. Look at her age..this is a little drastic don't you think" okay first of all I'm 23 I may be young but my weight had been a problem my whole life.. In the second grade I weighed 120lbs for peeps sakes.. once my Bariatric.cordinator told her that boy didthe tune change lol Anyone else have any bad comments from there insurance company? ..

Share this post


Link to post
Share on other sites

I am 23 as well, and I don't think it's drastic in the least. My pediatrician from birth to 20 gave me a recommendation letter along with a copy of my growth chart showing obesity at a young age. It would be drastic if we waited another 10 or 15 years and packed on another 50+!!

Share this post


Link to post
Share on other sites

Part of the pre approval requirements was a psych eval, when I got denied one of their reasons was because the evaluation was border line. Now, I know it may make me sound crazy being bothered by it, but I mean come on! I was so offended, and slightly hurt.

Share this post


Link to post
Share on other sites

Right?.. I couldn't imagine what I would look like if I continued at this weight and had kids.. Then my insurance company would have some serious problems.. Not to mention I've tried every diet in the book.. I've had a psych eval too.. Which I didn't understand.. They asked me about my parents.. Lol what do my parents have to do with me having lap band surgery.. The insurance company is just wasting all this money covering all of these non sense appointments lol

Share this post


Link to post
Share on other sites

Bb banded.. Did you get approved or are you still fighting with them?

Share this post


Link to post
Share on other sites

Thats exactly what I said, but I won't complain because at the end of the day, they kind lose either way.

Share this post


Link to post
Share on other sites

I'm still fighting. They changed a few things though, they have me on a 1500 cal diet, with excersize 3 hours a week. All of that is simple no complaints, but I also have to document anything I eat. **insanely time consuming**. And I can't gain anything, I think I made a mistake losing 6 lbs two weeks ago though haha. MY new date is 5/11/12. Crossing my fingers!

Share this post


Link to post
Share on other sites

Well don't feel bad good things come to those who wait those people that work with the insurance companies are real good at helping with getting it all taken care of. I went thru all of it and I am two times your ages.

Share this post


Link to post
Share on other sites

Haha.. Yah I have to lose eleven pounds in two Weeks.. for them to approve it and for me to be able to keep my original surgery date.. Which is March 28th.. That's the only thing theyre waiting for lol.. _good luck_We can do it!! =)

Share this post


Link to post
Share on other sites

Try not to "personalize" comments by the insurance company personnel...I have found that many such "professionals" are really ageny supp;ied with a minimum of training in the field.

I had to loose 20 lbs just to get scheduled for surgery...which I did (amazing what you can accomplish when you are motivated!). I was fortunate to have a primary care physician who is very experienced and knowledgable about the surgery, so I was approved with only one letter. My co-morbidities are what made the difference in my case.

Good luck...and keep your focus on the prise of better health!

Share this post


Link to post
Share on other sites

I had one hospital that did not even bother to call me on a gastric bypass and after being banded on jan. 27th 2012 I was happy to say thank goodness they did not call me. I have two insurance companies and one sucks it will not pay for anything I just have it because my work pays for it but it is truly a waste of monies and time my husbands paid for my banding less my copayment buti had to have the testing of everything found out had type II other medical issues.

Share this post


Link to post
Share on other sites

My surgeons office submitted my paperwork online but since I was using a photo for my 2009 records it was denied. So they turn around and mailed my paperwork. I called ins today to inquire about the status and the lady tells me and I quote "I'm not suppose to tell you this but since they denied it the first time they will prob deny it the second time, but I'm not suppose to tell you that" my heart sunk!! Why would you tell someone that??! I'm praying she is wrong!

Share this post


Link to post
Share on other sites

Don't take anything insurance says negatively...they want YOU to work for it and wiggle your way around their guidelines. If you are dedicated and meet the criteria, you will be approved. I had to go through a 6 month diet and 10 lb weight loss. I was so upset when I found out about the 6 months but instead of getting upset about it, I used that as a time to educate and prepare myself for the band. Research more about your insurance and about the band. Use this time to your advantage and you will get there.

I was 22 when I started my 6 month diet and had just turned 23 a month before my lapband surgery. My BMI was slightly over 41 and I had no comorbidities. Don't let anyone get you down! Just let them be your motivation and show them that you really want this AND that you can do it! :) You'll get there!

Share this post


Link to post
Share on other sites

I don't know if their comment was that bad. I think either they did'nt read your file very well or the doctor did not send the right documentation. If someone was a normal weight for 22 years and then gained a lot of weight in one year going immediately to WLS to me seems premature. The person may have a physical illness that is causing them to gain weight; or there may be a mental health issue behind their over eating.

Someone who has been overweight their entire life wouldn't be just jumping into WLS. By 23 I'd lost over 100 pounds TWICE. I wish the band had been available when I was that age.

Share this post


Link to post
Share on other sites

My surgeons office submitted my paperwork online but since I was using a photo for my 2009 records it was denied. So they turn around and mailed my paperwork. I called ins today to inquire about the status and the lady tells me and I quote "I'm not suppose to tell you this but since they denied it the first time they will prob deny it the second time' date=' but I'm not suppose to tell you that" my heart sunk!! Why would you tell someone that??! I'm praying she is wrong![/quote']

Manda, if you don't mind my asking.... What insurance do you have? I was also told that I may have to submit a photo for 2009 along with a personal letter stating why I was overweight and why I didn't see a doctor that year. - Kelly

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

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 1 reply
      1. BabySpoons

        Amazing! Congrats!!! Watch out for the sharks. 🦈

  • 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

    ×