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Trying Not To Get My Hopes Up Re: Insurance

tlm1120

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tlm1120    11

tlm1120
Posted

Hello, everyone! I am a 39 (almost 40) year old wife and mom of two awesome boys. I decided a few months ago that lap band surgery was the way to go. I have lost and gained and lost and gained for the last 10 years and I'm over it. I have Carefirst BlueCrossBlueShield and I feel like I've met all of the requirements, but I am afraid to get my hopes up. I go back and forth between a BMI of 39 and 40...of course the 40 is required. I plan to have a big lunch on Thursday before I meet with with the surgeon. ;) I feel like my future is in the hands of someone who doesn't even know me. It is such and uncomfortable feeling.

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Roxygirl    44

Roxygirl
Posted

Hello, everyone! I am a 39 (almost 40) year old wife and mom of two awesome boys. I decided a few months ago that lap band surgery was the way to go. I have lost and gained and lost and gained for the last 10 years and I'm over it. I have Carefirst BlueCrossBlueShield and I feel like I've met all of the requirements, but I am afraid to get my hopes up. I go back and forth between a BMI of 39 and 40...of course the 40 is required. I plan to have a big lunch on Thursday before I meet with with the surgeon. ;) I feel like my future is in the hands of someone who doesn't even know me. It is such and uncomfortable feeling.

I completley understand and was right there where you are a week ago before I found out I got approved. Keep the faith and think possitive! It will happen for you :)

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Roxygirl    44

Roxygirl
Posted

I completley understand and was right there where you are a week ago before I found out I got approved. Keep the faith and think possitive! It will happen for you :)

I forgot to tell you. I actually wore ankle weights in the begining to get me over that 40 BMI hump. Insurance requirements can be a challenge. Keep us posted!!

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tlm1120    11

tlm1120
Posted

Thanks, Roxygirl! How long did it take to get your approval?

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suzbuni    32

suzbuni
Posted

Good luck.

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tlm1120    11

tlm1120
Posted

Thank you, Suzi! Roxygirl...what a great idea!

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tlm1120    11

tlm1120
Posted

Suzi--I am going to the same practice! I noticed your surgeon's name...I'm seeing Dr. Averbach on Thursday. Were you happy with the practice?

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Roxygirl    44

Roxygirl
Posted

Thanks, Roxygirl! How long did it take to get your approval?

Well I first started out last December 2011 and then found out in February of this year that my insurance required a 6 month weight management. My last day for that was August 1st and my paper work was submitted to insurance on Friday, August 3rd and I found out Friday. So 7 days of complete misery waiting to be approved. Do you have any co morbidities?? I have 2 and a mils 3rd so I think that helped.

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Roxygirl    44

Roxygirl
Posted

I meant mild ;)

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tlm1120    11

tlm1120
Posted

No co-morbidities...never thought I'd be bummed about saying that! lol! The 6 month diet is a concern for me. I've done weight watchers for 6 months and have receipts and before that I did 8 months of Medifast with Health Coach and I have documentation. I am hoping they will accept all of this so I don't have to wait for another 6 month diet. I've been dieting for over a year and have lost and gained more pounds than I care to remember. I'm going to be a wreck waiting to hear for the decision. 7 day, huh? I hope that they just tell me...like ripping off a band aid!

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suzbuni    32

suzbuni
Posted

They took my weight watchers info fine. Yes I line the practice. Are you going to mapke lawn or the other office. Tina- manger/ insurance preop nurse- is really helpful. Have seen both doctors for fills. Both nice. Surgery was at St Agnes hospital. - Great staff and super supportive nurses. Everyone on floor was for WLS. First went in office in August 2011 had surgery 12/19/11. Started at weight watchers in June 2011. Lost 65 pounds so far. Bmi was 43 I think. Now 32. Good luck.

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tlm1120    11

tlm1120
Posted

So glad to hear that the WW was accepted. That's a huge relief! I am seeing Dr. Averbach in Catsonville on Thursday, but I'm hoping to go to Maple Lawn for follow up appointments. The Catsonville office had the first "new patient" appointment available. I'd rather drive a bit than wait any longer! I'm glad to hear that you felt comfortable with the practice! Thanks for the "review"!! :)

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Roxygirl    44

Roxygirl
Posted

No co-morbidities...never thought I'd be bummed about saying that! lol! The 6 month diet is a concern for me. I've done weight watchers for 6 months and have receipts and before that I did 8 months of Medifast with Health Coach and I have documentation. I am hoping they will accept all of this so I don't have to wait for another 6 month diet. I've been dieting for over a year and have lost and gained more pounds than I care to remember. I'm going to be a wreck waiting to hear for the decision. 7 day, huh? I hope that they just tell me...like ripping off a band aid!

My insurance required 2 years of weight history and diet attempts and then the 6 month requirement was through my bariatric DR and a nutritionist. Can you call your insurance and ask or do you have a member handbook to refer to??

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