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Federal BCBS FEP Basic coverage, straddling the BMI line.



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Howdy, I was hoping someone might have some insight to my situation. I attended my first seminar today and hope to schedule my 1st appointment soon, unfortunately that leaves me with more questions than answers at this time.

Anyhow - My BMI straddles 39.9-40.2 depending on the day it seems. I've been at 38+ for the last few years, marriage and a child seems to have helped it inch up a little. My concern is whether or not I can get approved without the typical comorbidities if I tally up at 39.9. The only thing I really have to work with is an old knee injury which makes walking an aching, painful experience and stairs are even more fun! I had a surgical repair performed which helped the problem, but it still hurts like tax season. I don't know if that would provide leverage for BCBS though, I can vouch that it has been a complete roadblock in getting in exercise and taking the weight off of it would help tremendously amongst other health benefits. Any thoughts?

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Re-check your height (an inch can put you in a higher BMI) and have you got documented efforts at weight loss attempts? I had been seeing a endocrinologist, did WW, saw a crackpot doctor and attempted nutri-system over the last 8 years. My nut said I was now just under 5'8" and therefore my BMI was a little higher. My BP and possible pre-diabetic state put me in the "good to go category".

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Height is accurate, though if I skip my boots and go with sneakers it might help :) I don't have any medically supervised/documented weight loss attempts in recent years, I did about 10 years ago but it suffered the same fate my latest personal attempts have, death by knee pain and rebounding. I have done several on my own in recent times with marginal results, I have that data on hand. I do have a family history of diabetes but I'm not in that neighborhood at the moment.

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I would honestly wear the heaviest clothes I could find to my consultations if I were you. I also have BCBS and it sucks that they are requiring me to complete 6 months of nutrition counseling before qualifying me for the surgery. I only say this because I was told by my counselor that if my weight drops below 40 BMI, that I will be disqualified. They are actually telling me to stay morbidly obese for 6 months but to follow the nutritional guidelines at the same time. Sounds kind of sick, right?

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That was kind of what I was afraid of <_< It wouldn't be a problem to put weight on but that's kind of NOT the idea lol. It sucks how insurance companies force you to jump hurdles to retrieve any of the money you've punctually supplied them with over the years.

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It's all a game... but eventually we will get what we want in the end... best of luck!

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FEP BLUE is 3 months of nut visits. Do you have your two year weight records documented? It can be from any of your drs. Also a great letter of necessity will help. Do you have GERD? I didn't have to have proof of WW I just told them what programs I has done. I have FEP BLUE BASIC and was approved for the sleeve quick. Now revising to bypass.

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Take your height without your shoes on. And yanno, we shrink as we get older.

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Have your height taken barefoot and chug a bottle or two of Water right before you weigh if a pound or two will make a difference.

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Turns out I've not measured myself shoeless in quite some time, the numbers are much better regardless of my scale's daily opinion. Thanks for the suggestion :)

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I have FEP BASIC also. They require the 3 months of weigh ins. I am currently at 40 bmi and I was told to maintain my weight until my last weigh on 8/3, then start pre-op diet for surgery schedule 8/14. It is killing me that I have to eat so much food to maintain when all I want to do is start my better eating habits. I agree with the "wear heavy clothes" comment. My first weigh I was under 40 and they can't include that weigh for the insurance approval, that's why I need my Aug weigh.

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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
      1. This update has no replies.
    • 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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      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
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