Jump to content
×
Are you looking for the BariatricPal Store? Go now!

freakin' insurance companies!!



Recommended Posts

I haven't been on here in a while... funny how life takes control of you sometimes instead of the other way around!!:faint:

But really here's my question- is there anyone out there that has MMO supermed plus and got approved for surgery? i feel that i may be getting the run-around about how my weight i need to lose in my 6 month documented weight loss attempt required for approval. so i guess i was just hoping for some feedback from people that got approved with them and how much weight did you lose in the 6 month thing? thanks a lot!!

Laurel

Share this post


Link to post
Share on other sites

<p>My insurance company will pay for 90% of the procedure, once I have satisfied 2 requirements. One, my doctor must put me on a documented, strict diet for six months. Two, I must be at BMI 40, for 3 years.</p> <p> </p> <p>So if I go on the strict diet and lose 50 pounds, for example, how can we document a BMI of 40 for 3 years (I'm at 40 now)? Of course we all know I will put the 50 lbs back on, plus 10. :)</p> <p> </p> <p>So the hell with it. I'm going to pay 'out-of-pocket' ($15K). If I live even another 5 years, it will pay for itself in other medical costs. Plus, its worth $15K to me to enhance the quality of life.</p> <p> </p> <p>My psych evaluation is next Friday. My personal doctor does the pre-op stuff the week after that, and away we go.</p>

Share this post


Link to post
Share on other sites

thank you for your help gmccon, but do you have medical mutual supermed plus? i think the problem i am having is with my particular insurance... i'm not sure. i understand what you are saying about losing hte wt. then they will say that you dont need the surgery- but my ins is saying that i have to lose "some weight" in the 6 months. august is my 8th month b/c at month 4 i had lost weight, but by month 6 i had gained it back. so i had to do 2 additional months to lose we, and they want me to be "a couple lbs" lower than my starting weight in january. in month 7 i was 1 pound under my starting weight, so i am trying to lose a few more before my appt in aug. but i just want to know if anyone knows exactly how much i have to lose to get approved, no one at the ins co will give me a straight answer. all the say is "some" or "a few pounds". thanks for any info anyone can give. ;)

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×