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

Recommended Posts

So I had my appointment with the Surgeon, and the first thing she tells me is that my insurance is changing their policies effective 4/15/18 to requiring 6 months supervised dietician visits. Because I am completely done with everything needed, she felt terrible. I’m rushing to get my pcp to send a letter stating I’m healthy for surgery in hopes that we can get the approval before the deadline, but I’m ready to cry. Getting to the end and having them tell me I might have to wait until August is heartbreaking.

PRAYING that my paperwork is submitted tomorrow with no issues and is approved before they implement this policy.

Going to go cry in my car while I wait for my PCP to call back.....

Share this post


Link to post
Share on other sites

I hope it all works out in ur favor...that's not fair though hopefully they can waive it for you since you have come so far

Share this post


Link to post
Share on other sites

That is some bs... hope everything works on your favor . 🤞🏽


Share this post


Link to post
Share on other sites

I am praying for you, too.

I had a set back last year when my employer switched insurance companies at open enrollment. They went from an *** that covered it with co-morbidity to one that only covered it with very serious co-morbidity. I ended up switching to the PPO option which was easier to qualify than the original but my co-payment went from $250 total to $2879 paid so far (I am still getting bills). This was very stressful, and to think if I had just started my 6 month diet 2 months earlier I could have saved over $2500.

Sorry, this was about you. I am pulling for you!

Share this post


Link to post
Share on other sites

27 minutes ago, Kay07 said:

So I had my appointment with the Surgeon, and the first thing she tells me is that my insurance is changing their policies effective 4/15/18 to requiring 6 months supervised dietician visits. Because I am completely done with everything needed, she felt terrible. I’m rushing to get my pcp to send a letter stating I’m healthy for surgery in hopes that we can get the approval before the deadline, but I’m ready to cry. Getting to the end and having them tell me I might have to wait until August is heartbreaking.

PRAYING that my paperwork is submitted tomorrow with no issues and is approved before they implement this policy.

Going to go cry in my car while I wait for my PCP to call back.....

If for some reason you have an issue, most insurance companies will also accept a signed form from either your surgeon or PCP in lieu of a class. Depending on the schedule this may at least cut the number of classes you need to do if you are forced to.

Share this post


Link to post
Share on other sites

While I understand your frustration....even worst case scenario....6 months isn't that long when you're talking about a life changing decision.

Also, using those six months to lose 30 or so pounds will make reaching goal that much easier after surgery.

Lifestyle changes are hard. Working on them hard before surgery pays off.

Don't mean to be insensitive....just trying to see it from another point of view.

Good luck however it turns out:)

Share this post


Link to post
Share on other sites

My heart goes out to you. Hope it works out all right.

Share this post


Link to post
Share on other sites

I know the feeling. Im

not sure what insurance you have but i know i had one of the BCBS reps in my pre-op post off class. She said to fight it if it’s not improved. As a matter of fact I would go ahead or even had my PCP and bariatic surgeon to submit a personal statement pledging your case. You only recently found out this and everything is complete. Wollow for a few minutes but be proactive with the Statements. Again this came personally from an insurance rep. Even though August is not that long when you have your mind set on something and anticipation high, August seems far off. Believe me I know that’s why o elected to lay for my surgery but my situation is a little different. My circumstance was I changed insurance and I was not willing to wait as I had everything completed. Howeve defintley fight for yours!!!

Share this post


Link to post
Share on other sites

I'm sorry you just learned this! ((hugs))

But, if that does happen, you will handle it. It's the switching in mid-stream and adjusting your expectations in the middle of the process.

This happened to me. I was denied first time and told I had to do another 3 months. But in the end, the time passed quickly. And I was approved the next time. Just hang out here and post a bunch!!!

Share this post


Link to post
Share on other sites

Thanks everyone! I've put my big girl pants back on and going to do everything I can to get that paperwork submitted. If for some reason I get denied, I'll appeal but in the mean time keep up with the plan. August feels so far, but the truth is it would probably be later than that unless I can get the first week. September through January (minus xmas break) are insane at work, and I am pretty sure my team would kill me if I was out for a few weeks.

On the plus side, if it DOES go through, I am looking at an early May surgery date. I am also down 17lbs!!! I mean if you subtract the 9lbs I ADDED switching to this diet, I am only technically down 8lbs but I'll freaking take it!

Share this post


Link to post
Share on other sites

oh hon im sorry that sucks but yeah insurance companies are something else arent they. but hey it will all work out in the end ok

Share this post


Link to post
Share on other sites

I’m so sorry that you received this news. Had I gotten everything done except my pcp letter, I would have had a meltdown too. It is a lot to go through to get to that point only to find there’s been a change that messes up the timeframe you thought you were working with. Hang in there. I’m hoping something happens soon that will allow you to get your surgery in May. Prayers and warm wishes sent your way. 🌻

Share this post


Link to post
Share on other sites

When things like this would happen, my mother used to say "Everything happens for a reason" or "That must be how god wanted it." She died 22 years ago and while I still miss her, I do not miss her saying stupid **** like that. She dealt with everything on an emotional and spiritual level. But you know what? Sometimes **** happens, and it can hurt, but you just have to deal with it and move on.

After being raised with stuff like that I taught my kids that when something bad happens, go ahead and let yourself experience the emotions you're feeling, but do it quickly then put them aside and address the problem immediately and with a clear head. There's always plenty of time to get emotional later.

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

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.
    • jparadigm

      Happy Wednesday!
       
      I hope everyone is having a lovely week so far! 
      It's been a bit of a struggle this last week...I'm hungry ALL the time.
      · 1 reply
      1. BlondePatriotInCDA

        Have a great Wednesday too! Sorry you're hungry all the time, I'm pretty much the same..and I'm sick of eating the same food all the time.

    • ChunkCat

      Well, tomorrow I go in for an impromptu hiatal hernia repair after ending up in the ER over the weekend because I couldn't get food down and water was moving at a trickle... I've been having these symptoms on and off for a few weeks but Sunday was the worst by far and came with chest pain and trouble breathing. The ER PA thinks it is just esophagitis and that the surgeon and radiologist are wrong. But the bariatric surgeon swears it is a hernia, possibly a sliding one based on my symptoms. So he fit me into his schedule this week to repair it! I hope he's right and this sorts it out. He's going to do a scope afterwards to be sure there is nothing wrong with the esophagus. Here's hoping it all goes well!!
      · 3 replies
      1. AmberFL

        omgsh!! Hope all goes well!! Keeping you in my thoughts!

      2. gracesmommy2

        Hope you’re doing well!

      3. NickelChip

        I hope it goes well! Sending positive thoughts for a speedy recovery!

    • jparadigm

      Hello lovlies!
      Today is a beautiful day in west Michigan! I hope you all have a beautiful Tuesday and rest of your week!! 🤗
      · 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

    ×