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I was denied because I hadn't had a BMI of 40 or above in the past 3 years, and I didn't have the required co-morbidities for the past 3 years. I do have co-morbidities, just not the ones that they recognize. I have high cholesterol, GERD, borderline diabetes taking Metformin to prevent getting full blown diabetes, knee problems and moderate sleep apnea.

I found medical records showing my high cholesterol for longer than 3 years, and I have a strong family history of diabetes, so I'm hoping that will be enough. I also found where I weighed in with a 39.1 BMI back in 2011, so that may help.

Oh ok. Can you get your doctor you see about your knee to write a letter saying if you were to get some weight off your knee that it will help with the problems you have been having? With my insurance (Aetna) GERD and sleep apnea are recognized. I have both of them.

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I was denied because I hadn't had a BMI of 40 or above in the past 3 years, and I didn't have the required co-morbidities for the past 3 years. I do have co-morbidities, just not the ones that they recognize. I have high cholesterol, GERD, borderline diabetes taking Metformin to prevent getting full blown diabetes, knee problems and moderate sleep apnea.

I found medical records showing my high cholesterol for longer than 3 years, and I have a strong family history of diabetes, so I'm hoping that will be enough. I also found where I weighed in with a 39.1 BMI back in 2011, so that may help.

Oh ok. Can you get your doctor you see about your knee to write a letter saying if you were to get some weight off your knee that it will help with the problems you have been having? With my insurance (Aetna) GERD and sleep apnea are recognized. I have both of them.

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I was denied because I hadn't had a BMI of 40 or above in the past 3 years, and I didn't have the required co-morbidities for the past 3 years. I do have co-morbidities, just not the ones that they recognize. I have high cholesterol, GERD, borderline diabetes taking Metformin to prevent getting full blown diabetes, knee problems and moderate sleep apnea.

I found medical records showing my high cholesterol for longer than 3 years, and I have a strong family history of diabetes, so I'm hoping that will be enough. I also found where I weighed in with a 39.1 BMI back in 2011, so that may help.

Oh ok. Can you get your doctor you see about your knee to write a letter saying if you were to get some weight off your knee that it will help with the problems you have been having? With my insurance (Aetna) GERD and sleep apnea are recognized. I have both of them.

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I've included my knee problems with my other medical information. I actually had surgery on my right knee a year ago due to a torn cartiledge, but since then, both knees are stiff and painful. I have had to resort at times to getting a cart at Walmart to shop. I've bought a cane to help when I need it also. They wake me up at night sometimes hurting.

BCBS recognizes sleep apnea, but only when it is severe, not moderate like mine, and I was only diagnosed last April, not 3 years ago, although I've probably had it for 3 years.

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Oh ok! Well ill be praying that God touch who ever your dr will talk to for the peer to peer!! Keep me posted! It will work out!

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LFG do you know "God is a wonder to my soul"? I think of the song when I hear of stories like yours. Surgery is around the corner. And health benefits to follow. God is a wonder...

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LFG do you know "God is a wonder to my soul"? I think of the song when I hear of stories like yours. Surgery is around the corner. And health benefits to follow. God is a wonder...

Yes he is. I prayed and I said God its in your hands. I was doubting and I prayed and told God to help me with that and he did!! God is wonderful. Have you hear William Murphy "It's working"? WONDERFUL SONG!!!

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Your story truly shows the power of prayer. I waited and prayed for two years about this surgery. I wanted the sleeve but my insurance did not cover it at the time. Late January last year I became very ill and was in the hospital for several days. I was told that I have copd on top of high blood pressure, no thyroids, sleep apnea, and diabetes. I was told I had to get the weight off. After several months of steroid shots I continued to gain. In July I really started praying that god make a way for this surgery. I called and got the process started in August. I found that my insurance now covered the sleeve and my out of pocket went from 2500.00 to 375.00. So God had not only answered the prayer for surgery, but answered the financial part too. Due to being in the hospital early in the year I had the surgery and only spent around 200.00. I no longer have the high blood pressure, diabetes, or sleep apnea. I am now down over 60 pounds and had surgery Oct. 30. We serve a great god.

Edited by Sherry73

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Your story truly shows the power of prayer. I waited and prayed for two years about this surgery. I wanted the sleeve but my insurance did not cover it at the time. Late January last year I became very ill and was in the hospital for several days. I was told that I have copd on top of high blood pressure, no thyroids, sleep apnea, and diabetes. I was told I had to get the weight off. After several months of steroid shots I continued to gain. In July I really started praying that god make a way for this surgery. I called and got the process started in August. I found that my insurance now covered the sleeve and my out of pocket went from 2500.00 to 375.00. So God had not only answered the prayer for surgery, but answered the financial part too. Due to being in the hospital early in the year I had the surgery and only spent around 200.00. I no longer have the high blood pressure, diabetes, or sleep apnea. I am now down over 60 pounds and had surgery Oct. 30. We serve a great god.

Now that really was God. We serve a wonderful God. Yes we do!

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Honestly, I think it's like applying for disability. They know that you qualify in the very beginning but I think they've made it standard practice to deny the initial application just hoping that many people will give up, which so many do and don't take advantage of the appeals process.

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Bamaboo64

Your right. Lots of people do give up and don't fight. But they should fight for it. But what I don't understand is why insurances make it so hard. Think about it, people having the surgery will save them money in the long run because It will cut out alot of health issues by losing weight

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Do you have a surgery date yet? If not, you need to let us know when you do so we can pray for you that day!

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Do you have a surgery date yet? If not, you need to let us know when you do so we can pray for you that day!

No I dont have a date yet. I called the coordinator at my dr office today to let her know my denial was reversed. So I had to email her a copy of the letter Aetna sent me. She called me back and said the lady that does the insurance had to verify my benefits for 2014 and that they will call me to set a date!

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Yippie!!!!! Keep us updated.

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Yippie!!!!! Keep us updated.

I surely will!!!!

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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.
      · 0 replies
      1. This update has no replies.
    • 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💪
      · 0 replies
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
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