So BCBSNC denied me because my BMI is 51 and it has to be 50 or less. I have been doing the low carb diet and watching what I eat when I eat and how much I eat and I still have not lost enough. I need to lose about 6 lbs. before I can even request to have an appeal. I am so discouraged... I have starved myself, been weak, but still tried to keep my head up thinking that I would come out on top of this thing and it did not happen. Everytime I eat now, I think "Stupid, what are you doing to yourself?" I had all the faith in the lord that he would get me an answer quickly from BCBS and sure enough it happened, but I got the answer that I told myself was unacceptable. No was not even an option for me. I have read to see if my insurance will cover the bypass but reading over the info is even more discouraging because the requirements for bypass is so much more. I don't understand how they say I am too fat to have the weight loss surgery. If I could do this all by myself I would not have a weight problem.

I called BCBS and had a talk with them. When I found out I was denied on 6/12, I had about 15lbs then to lose and I have lost all but about 6lbs to be under what they want. I told the guy that he can guarentee that he will have an appeal on his desk in 2 weeks. I have one week to go. I will leave for the beach next Sat. and I wanted to be weighed and have an appeal in progress while I was on vacation so I could try and have a good time and not have all this to think about. I also said quiet a few other things as well to that poor guy that had nothing to do with making the decision. I explained to him that I was not angry with him but he needed to note my file. This is what I told him to NOTE:

Since I have paid BCBS for so many years, and now that I need them, if they decide not to help me, they will never get another dollar of my money even if I have to walk the face of this earth with NO INSURANCE. Granted they would get my money until the end of the year, I told him that he should also pass along that they have not even began to see CLAIMS! I went to see a Neurologist and they sent me a letter wanting to know why....hahahaha how funny. They need to go ahead and plan on seeing a lot more of those. I'll go every single day if I have to and to physical therapy for my chronic back pain. I did elect in the smart flex program to cover my out of pocket exspense for the surgery that I did not get approved for so they can guarentee that I will spend every cent of it on making sure that they pay pay pay pay pay. (This is the angry part).

I'm sorry peps, I just needed to vent. I guess I will go walk another 10 miles and drink 5 gallons of water and take 4 fluid pills. MAN THIS SUCKS!

Just a suggestion. Go on the carnation instant breakfast sugar free 0 carb. For a week you should shed those 6 pounds easy. My gastric bypass doctor has all his patience go on this for 10 days before surgery. You mix it with skim milk drink six of them a day and nothing else except water. I loss 17 lbs before surgery.

I am sorry to hear you are going through all this and applaud your efforts to lose the wait but please please do not hurt your self by not getting the proper nutrients. Take the fluid pills only if your doctor tells you to. You can deplete potassium and can have a heart attack or stroke. Starving is never the answer. Best of luck to you.

me again the dummy who cant spell weight! (not wait- hope at least my mistake made you smile!

So BCBSNC denied me because my BMI is 51 and it has to be 50 or less. I have been doing the low carb diet and watching what I eat when I eat and how much I eat and I still have not lost enough. I need to lose about 6 lbs. before I can even request to have an appeal. I am so discouraged... I have starved myself, been weak, but still tried to keep my head up thinking that I would come out on top of this thing and it did not happen. Everytime I eat now, I think "Stupid, what are you doing to yourself?" I had all the faith in the lord that he would get me an answer quickly from BCBS and sure enough it happened, but I got the answer that I told myself was unacceptable. No was not even an option for me. I have read to see if my insurance will cover the bypass but reading over the info is even more discouraging because the requirements for bypass is so much more. I don't understand how they say I am too fat to have the weight loss surgery. If I could do this all by myself I would not have a weight problem.

I called BCBS and had a talk with them. When I found out I was denied on 6/12, I had about 15lbs then to lose and I have lost all but about 6lbs to be under what they want. I told the guy that he can guarentee that he will have an appeal on his desk in 2 weeks. I have one week to go. I will leave for the beach next Sat. and I wanted to be weighed and have an appeal in progress while I was on vacation so I could try and have a good time and not have all this to think about. I also said quiet a few other things as well to that poor guy that had nothing to do with making the decision. I explained to him that I was not angry with him but he needed to note my file. This is what I told him to NOTE:

Since I have paid BCBS for so many years, and now that I need them, if they decide not to help me, they will never get another dollar of my money even if I have to walk the face of this earth with NO INSURANCE. Granted they would get my money until the end of the year, I told him that he should also pass along that they have not even began to see CLAIMS! I went to see a Neurologist and they sent me a letter wanting to know why....hahahaha how funny. They need to go ahead and plan on seeing a lot more of those. I'll go every single day if I have to and to physical therapy for my chronic back pain. I did elect in the smart flex program to cover my out of pocket exspense for the surgery that I did not get approved for so they can guarentee that I will spend every cent of it on making sure that they pay pay pay pay pay. (This is the angry part).

I'm sorry peps, I just needed to vent. I guess I will go walk another 10 miles and drink 5 gallons of water and take 4 fluid pills. MAN THIS SUCKS!

Do a liquid diet (hight protein drinks) like Atkins and you will loose weight and cutthe carbs and sugar best of luck to you and stay strong!

I want to thank you all for giving me words of encouragement. I am going to beat this thing... I have too. I am not a quiter, I just got to keep faith that God will give me this when he is ready for me to have it. I just hope he decides to do it before I die of obesity, at least for my 2 year old son's sake. I've read more and more on BCBSNC on here and it seems that they usually approve everyone at some time or another, so I will just make sure that they keep hearing from me until they say "Gosh... just approve her so she will stop bothering us" :redface:

Does anyone know if you have a limit on appeals?

Hi! I'm so sorry that you're going through this, but it seems like you're doing a great job! I just have some quick advice about the low carb thing. PLEASE BE CAREFUL!!! I was on Atkins for 2 years. I lost 100 pounds on it, but toward the end I was desperate to lose more, so I cut my carbs back below 20g/day. I got so sick that I passed out at work and ended up in the hospital. I didn't know that our brains run predominantly on carbohydrates and require a minimum of 20/day. Don't go too far on cutting them back, but if you are counting them and are getting a lot, just know that you can cut back to as few as 20/day and still be okay. Good luck and keep up the good work. You'll make it! :biggrin2:

Stick with it Brandi! You can drop those last 6 lbs.

Also, you might want to check with Walter Lindstrom, the lawyer who helps with these sorts of appeals, if this next appeal doesn't work. I hear he's good and that it is cheaper than paying for the band yourself if he can get you covered by your insurance. (not to mention if you have complications, it's way better to have insurance coverage than being self-pay)

I hope the liquid diet works. Seriously, something like Medifast might be exactly what you can do to take off 6 pounds safely in a short time.

I applaud you! You've done a great job, don't let them frustrate you into eating or giving up. Just think how much better prepared you will be when you are finally banded. The Lord did answer, listen, he's saying wait until you are safe! Remember eating our way through vacations is never an option for us, eat healthy and enjoy every mouthful. Have a great vacation!:redface:

Hey Brandilf...

You are so close! It is only a few more pounds and you will be under 50. Don't give up! Don't be sad. You can do it; you are almost there. We will send supportive thoughts so you won't feel alone. We want you to succeed, too. And you can and will!

So sorry to hear about this!! Hang in there...

Come on!!! You can do it. Don't let a faceless insurance company tell you that you can't. Jumping through their hoops in a real pain in the ass but in the end your going to be stronger and healthier and happier. You really do want the insurance company to cover your band...if anything goes wrong you know that you'll be covered. If you can lose 15lbs...then you can lose 6 more lbs. You should be very proud of yourself for losing the 15lbs. that you did. I know you'll do great.