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So frustrated! :(

lena leeann

By lena leeann, in Insurance & Financing

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lena leeann    20

lena leeann
Posted

When I first called my insurance 3 months ago and got the list of requirements ... I made it a point and asked not 1 but 2 reps if I had to do a weight loss plan, they both said no! Now here I am 3 months in and they are say I need 6 months or 2 different 3 months:(. I sent in my membership to weight-watchers online, my slim fast membership and plan , proof from a dr that I used for weight loss for a few months and gym membership I've had from 2010 till now(shows my visits, but not my weight). Also documents from my PCP where he noted my weight and issues from 2011 and 2012,But all this is combined from a 2 yr period. So my approval is pending.... My heart is so broken I have a feeling I might still get denied. I have BCBS tx....... Has anyone went through something similar?

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bandicootc    91

bandicootc
Posted

I had the same experience, but I went to true results after stressing about it and since they were so experienced they were able to do all of that paperwork with the insurance company for me. It's very frustrating. If you meet the minimum requirements, don't worry. It will happen.

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DrmBig4Evr    152

DrmBig4Evr
Posted

Keep notes of whom you spoke with, dates and there is always a reference number generated. That way if they do deny you will have references that they can look up in an appeal. Requirements differ from policy to policy. I didn't need one for BCBS NJ, but I did need one for UHC a few years ago. The one I did need for BCBS is a "listing" of my weight loss attempts and failures and they accepted it.

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lena leeann    20

lena leeann
Posted

Thanks, will do.... But just incase I've already scheduled an appt with my PCP, to get the 6 months started, is it faster just to go ahead and appeal or do my 6 months if i get denied? Does anyone know? Let me add I don't mind doing the 6 months, just wish I had known 3 months ago.

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DrmBig4Evr    152

DrmBig4Evr
Posted

I'd start the 6 months and then appeal at the same time. An appeal usually takes about 15-30 days depending upon their turn around time.

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lena leeann    20

lena leeann
Posted

I'd start the 6 months and then appeal at the same time. An appeal usually takes about 15-30 days depending upon their turn around time.

Thank you very much for the info! :)

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mark!    449

mark!
Posted

Congrats girl!!! I remember the day I was approved, holy crap a rush of emotions. So happy for you.

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lena leeann    20

lena leeann
Posted

Congrats girl!!! I remember the day I was approved' date=' holy crap a rush of emotions. So happy for you.[/quote']

Thanks!!! I'm excited!!

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Bebee    33

Bebee
Posted

Congrats.. Im Apr 2nd

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flmama    105

flmama
Posted

I had the exact same thing happen! Originally they said no diet, then when we submitted they said 6 month diet...then they surprisingly approved me any way! I'm scheduled for April 11th! :)

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Go To Topic Listing Insurance & Financing

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

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        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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      Officially here for a long time, not just a good time💪
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