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Am i wasting my time?



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Hi everyone. I have BC/BS of Maryland. I'm not sure if I'm wasting my time or setting myself up for disappointment. I was wondering if anyone here has a similar story to mine and if so, how did it turn out? Ok so the criteria for my ins is pretty basic. 1. 40+ Bmi ; 2. 35-40 bmi with one comorbid (their comorbids are sleep apnea, diabetes, hypertension or "any other serious illness or medical condition related to weight") ; 3. Psych Eval. ; 4. 6 moths supervised weight loss.

That's it. My only issue is my BMI according to BC/BS is 38.9. None of the comorbids. I'm getting tested for sleep apnea soon. Hopefully it will come back that I have sleep apnea. If not someone suggested I gain the extra 8-10 lbs needed to hit a 40 BMI. I start the weight watchers meetings next week. I guess I will contact a bariatric surgeon after I get my sleep apnea results? Or should I contact them

Now?

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I would contact them now and let them know where you are at. I actually gained 6 lbs on purpose to meet the requirements, plus I had high cholesterol which counted as a comorbidity. I thought it was a "long shot" that my insurance would accept me. But they accepted me, and I am so glad they did. It was worth the trouble.

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Do you have any documented back/hip/knee issues? BCBS-IL counted my lower back issue as a comorbidity. Good luck and either way, I don't think you're wasting your time. It's well worth the fight.

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Thanks for the reply! Ok I wasn't sure if I should wait or do it now because I've heard of insurance companies going by the weight of your first surgeon appt. I also have high cholesterol, maybe that falls under their generic comorbid -'any other medical condition due to weight'. They don't really elaborate on that.

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No but I do have documented neck problems, degenerative disc disease that my chiropractor says is from weight

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To gain a few pounds now to help you for the rest of your life may be worth it. I also had BCBS and I had no problems getting approved, just had to do all my pre-op stuff, I was just at 40 BMI.

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If its a matter of gaining less than 10 pounds to qualify - I say go for it!

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Wear combat boots when you get weighed for the insurance! Seriously, the high cholesterol and neck and back problems should qualify. No matter what your starting weight, they will want you to lose a few pounds to decrease the size of your liver before surgery any way. So if you were close to the BMI weight, you might be a little under after dieting for surgery any way.

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I have same BC/BS Maryland too (CareFirst MD). My BMI hovers between 36-37 and I have hypertension & high cholesterol.

I'm in 6 month program at GBMC. Are you working with a program now? The one at GBMC has guided me through the process step by step. They provided a ton of info, nutritionist, etc. Had psych eval, etc.

My 6th visit is on 6/4/13 when they schedule surgery and submit for insurance approval. I'll be holding my breath until I hear if it is approved since the policy was just revised on 3/25/13. .

I don't think you are wasting your time, especially if the sleep study comes back positive for apnea.

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I have Anthem BCBS. I started my processing on March 16 starting with the seminar. 4 days later I met with the surgeon. I needed to gain 13 pounds because my bmi was 38 with no commodities. Finally on April 30th I was at my 40 bmi. Had my psych appointment on May 16 she told me that she was clearing me. Just waiting on insurance approval.

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I added on 10 pounds weights when I seen the surgeon & my physical under my breast. U have to loose weight before surgery anyways. I wa approved Mat 18th

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My surgery days is July 8

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I had a bmi of 36.1 and it turned out I had severe sleep apnea. I had no idea!!! Are you tired in the morning? No energy? Do you snore? Has anyone told you that you are very restless in your sleep?

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Hi everyone. I have BC/BS of Maryland. I'm not sure if I'm wasting my time or setting myself up for disappointment. I was wondering if anyone here has a similar story to mine and if so' date=' how did it turn out? Ok so the criteria for my ins is pretty basic. 1. 40+ Bmi ; 2. 35-40 bmi with one comorbid (their comorbids are sleep apnea, diabetes, hypertension or "any other serious illness or medical condition related to weight") ; 3. Psych Eval. ; 4. 6 moths supervised weight loss.

That's it. My only issue is my BMI according to BC/BS is 38.9. None of the comorbids. I'm getting tested for sleep apnea soon. Hopefully it will come back that I have sleep apnea. If not someone suggested I gain the extra 8-10 lbs needed to hit a 40 BMI. I start the weight watchers meetings next week. I guess I will contact a bariatric surgeon after I get my sleep apnea results? Or should I contact them

Now?[/quote']

Perhaps you are a inch shorter ?

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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.
      · 1 reply
      1. LeighaTR

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    • 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

        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.

    • CaseyP1011

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