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UHC Denied, but have sleep apnea test tonight



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UHC denied me with my BMI @ 38.7.... I recently have been put on medicine for a weak bladder and have pitting edema. Tonight I am having a sleep apnea test. I'm still hoping there is a chance that I will be approved for the lap band. Any suggesions out there on what I should do or on the sleep apnea test? Thanks!!

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so the sleep apnea test went well... I get the "official" results from the doctor tomorrow. They did tell me that I don't quit breathing but that I toss and turn and move all night long to include coughing. I knew I was tired all the time but they said that I would always wake up before the 4th stage of sleep which is the most important. They said they were "tired" watching me all night b/c I moved so much. Do yall think they will put me on one of these machines or classify this as sleep apnea? I'm wondering what they will do and if insurance can use this as a comorbidity.... Any thoughts?

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Hi guys...i dont know if im in the right place to ask this question but...I have UHC ppo. They cover 90% for bariatric surgery. Ive done all my testing. sleep study, ekg, blood, urin, chest xray and endoscopy. Then "today" my surgeons office tells me that i have to have a five year history of having a bmi over 40 or two co morbidities. First of all...why didnt they tell me this at the beginning? and second is this stated in my policy? they flat out told me all of a sudden that it wont be approved by my insurance? This is such a slap in the face. Ive been over weight all my life, my bmi is 40 and i weigh 230 lbs. 5'3". Yes my weight has dropped 5-10 lbs up and down forever but COME ON. thats rediculous! Does anyone have any recommendations or ideas, answers, hope??confused.gif

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my insurance states a 35 bmi with comorbidities or 40 bmi. I would still submit your stuff. You never know. I just sent in ap appeal in hopes of having my overturned.

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thank you!!! I will try. I cant even believe the office didnt even encourage me to try anyways?? especially after all ive been through! I just left a message for them to call me back.

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Sorry you got denied I know how that feels as I just got denied today by MEDICARE ADVANTAGE PLAN through SECURE HORIZONS through UNITED HEALTH CARE. MEDICARE approves lapband but an MEDICARE AVANTAGE PLAN doesn't this made no sense to me and I have been on the phone almost all day long with the various Insurances and the Drs. I still haven't heard back a thing. I have a BMI of over 50 with HBP, spinal stenosis, 2 bulging disc, 1 herniated disc and half of a right hip bone, can't walk without canes, must use a scooter for shopping and I get denied. I am so pissed!!!!!!!!!!!!!! They will NOT win I WILL!!!!!!!!!!!!!!!!!!!!

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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.
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