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Denied over 12 pounds!

well, my fear came true this morning-my insurance denied me. i called to find out why, and it's because my bmi is over 50-basically, i was 12 pounds over the limit for getting a lapband! i just wanted to scream! i had heard of this nightmare, but figured i was so close they couldn't deny me===HAHAHA!!!so, of course when they weighed me, it was the day before i quit smoking...so now i have about 25lbs to lose before they will approve me! what a joke! any suggestions for the latest starvation diet? i'm on a mission and i'm not going to give up! iceberg lettuce and water sounds like a perfect lunch today (and every other day until i get my way)...lol

hope to hear from my wise bandster friends!!!!

~courtney

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  • niecyrenee
    niecyrenee

    Stupid insurance! I'm sorry you are having to go through this. I have tried about every diet known to man and the best, hands down, is the meat & egg fast. It takes the weight off fast but it's no

  • My company approved me and my BMI was somewhere over 50... between 52 and 56 somewhere. I guess I should feel even luckier! Honest? I would never advocate it for long term results, but if you want

  • losingjusme
    losingjusme

    i just cannot believe an insurance company would deny someone WLS for weighing too much. good luck and keep pushing it. you'll get there!

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Hi Chubbola,

By any chance do you have BCBS of Alabama? I just wondered because I was denied at first too. My BMI is 59 but my doctor had to write a letter saying it was medically necessary as he has been treating me for morbid obesity for over 11 years. We just resubmitted the letter and are awaiting for a response from the insurance company.

YOU CAN lose those 12 pounds - you know you can - take care and hang in there.

shelli:girl_hug:

Yup I agree Adkins Induction will help you lose. I have lost 6.5 lbs this week. Im doing it because I was told my insurance is going to want me to try some weight loss plan that has to be monitored by a Dr.

My company approved me and my BMI was somewhere over 50... between 52 and 56 somewhere. I guess I should feel even luckier!

Honest? I would never advocate it for long term results, but if you want to drop weight fast, follow the induction phase of the Atkins diet. It's truly not something you want to live with (trust me, I did it for well over a year, and had to live with the consequences), but chances are you will lose weight and lose it quickly. Weight, not fat. I should clarify - you will lose fat, eventually. But in the beginning when your ketosis kicks in, you will be losing mostly Fluid. It's not uncommon for people to lose 10+ lbs in their first week.

  • Author
Hi Chubbola---

I don't know what to say on the whole insurance thing, but what I am going to say is whoo hoo on the smoking. You seem to be doing great, how did you quit because I am only a day or so from quitting myself. Was it hard and what did you do?

i just woke up and realized that i REALLY want to change my life. every time i think about smoking, i try to remember why i quit. i continue to keep my 'eye on the prize'...i want to be banded more than anything right now, and NOTHING is going to stop me! you can do it-just remember that it's all worth it in the end! good luck!

  • Author

yeah---i'm not real happy right now-i'm pretty much starving...i think i might try atkins induction-at least i can eat things that fill me up-carrots and celery and yogurt aren't doing the trick---i've eated 12 points every day (weight watchers) and for my weight i'm supposed to eat 32---i just feel so desperate and mad all at the same time! i'll keep plugging away though, like i said before 'keep my eye on the prize', right?!

thanks for all your support!

Protein is your friend. Start with a protein shake, have a few ounces of protein at lunch with maybe a vegie and repeat at dinner. You will lose the weight. Best of luck. Julie

I hate insurance companies! I really feel for you. I agree that protein, will help with the appetite. Try to keep your spirits up. It is so worth it! Hang in there!

sam

It infuriates me that insurance companies have the final say on OUR HEALTH! This surgery could save your life! I am a self pay because my insurance has an exclusion against any kind of weight loss surgery. In less that a year I am down 110 lbs, no longer use blood pressure meds or acid reflux meds or my CPAP machine. My insurance company is now benefitting from my weight loss! They are saving thousands of dollars a year (in prescriptions, CPAP supplies, etc) and I am still paying my 401K back the $18,000 grand that I had to borrow from it in order to be banded. INSURANCE COMPANIES ARE EVIL! Can you believe I'm still this pissed after almost a year?:girl_hug: I wish you nothing but luck! YOU LOSE THAT WEIGHT AND MAKE THEM PAY FOR THAT BAND!! YOU CAN DO IT!! I promise you that the weight loss and improvement in your overall health, appearance and self-esteem will be more that worth what they are putting you through right now! Go get'em ladies!:clap2: Please keep us posted on your progress!

***OK, I'm climbing down from my soap box now***

Hi Chubbola---

I don't know what to say on the whole insurance thing, but what I am going to say is whoo hoo on the smoking. You seem to be doing great, how did you quit because I am only a day or so from quitting myself. Was it hard and what did you do?

I quit too. My doc put me on Chantix (http://chantix.com) and it works great! Even when I tried using the Patches, I had some cravings. Not so w/ chantix. I've met others who've tried it too and said the same thing.

Good luck!

Welp, The only way i can loose weight fast was with the clear liquids. No fun but honestly, if ya do it every other day and then do slimfast or a low carb shake w/salads n veggies for the other days. Im going to try this to for a bit. as soon as i got off clear liquids my weight loss stalled and i've been a good girl(mostly B)) with what i eat. I sure hope this helps ya! Take care. You'll do great im sure

:angry Damn those friggin' insurance companies and doctors' offices! I was denied today too! My BMI is just under 37, but I have diabetes, high blood pressure and high cholesterol/triglycerides. They want to see FIVE years' worth of medical records before they'll even consider approving me! Three years with my current PCP plus the psych letter from a psychiatrist I've actually been seeing for about 7 years aren't enough. So the WLC faxed a records request over to my old PCP's office. I called to follow up and get an ETA and was told that since I hadn't been seen in their office for over three years that it would be 7 to 10 days, plus they were going to mail my records, they won't fax them. That's going to add another two weeks to the process, not to mention how long it's going to take the insurance company to review my case. How many f'ing hoops do I have to jump through to prove I've been fat for 34 of m 42 years?!? The insurance company has probably spent more on me for prescriptions and Dr visits in the last two years alone than WLS will cost them to cover. I'm just so PISSED!!!

I use BCBS of Alabama. I knew they weren't going to cover it and went in as a self-pay. I told the doctors I'm not claiming it, but gave them my insurance card for the psychological evaluation and something else my insurance would cover (don't remember what now).

I got a letter yesterday from BCBS.. I didn't submit, I guess my doctor did.. saying I'm denied for coverage and detailed info on my policy.. ;)

Nice to know.. I'm still claiming major medical, that should reimburse me for some of it. My employer is helping me with the papers, he knows how our insurance is set up and likes to pay games with companies like this. If I get some money back, I'll be extatic (sp). If I don't, I'm still bouncin off the walls cause I'm BANDED!

And congrats x1000000 on stopping smoking. I just can't. I know you have to want to quit smoking. I want to lose weight, smoking is back in my mind right now. I'm not as strong willed to conquer 2 things like this at once. I need one of my vises to fall back on. So kudos to you! I plan to stop smoking when I want to have kids.. I want to have kids as soon as band heals..I'm giving myself 2 years. So in 2 years when I'm skinny (and married..) I'm going to quit smoking.. and then have kids. :clap2:

Sorry to hear this. If I were you, I'd just drink 3 or 4 protein shakes a day--no solids. Just do the average pre-op diet. Most of us lose quite a bit during that phase.

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