Hi everyone...

I have just had my 1 on 1 consultation with my surgeon yesterday. It appears that I have some Hoops to jump through for my insurance Company (BCBSIL). Ill be having a psychological evaluation (guess I wont tell her about the voices) and a Nutritional consult also. I also have to lose a bit of weight before the surgery, but with as much as the insurance wants me to do, I will have some time to do that.

So, are there others out there like me who are just starting this process and wanting a place to share info, vent or just flat out complain? LOL

They also took my picture yesterday, what is with that? if I have to lose weight BEFORE the surgery..shouldnt that be when they take the pic? I want all the credit for all that I get accomplished prior to surgery!!

:crying:

Edited May 13, 200917 yr by DEBPROBST
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Yes there are lots of hoops to jump through, I was amazed I knocked mine out pretty quick and am having surgery on the 28th. On the picture they want you at your biggest, so they can show you the difference as you progress so now is the time to take it. I had to do the psych eval, nutritional eval, referral from family doctor, sugery eval, seminar, insurance approval, surgery preop, blood work and ekg... and lose 10 lbs before sugery so I am doing 1200 calories a day... good luck to you.

Congrats on the surgery date!! I hope that everything goes perfectlly!! I cant wait for mine and if all else fails and I have to do the 6 month supervised dieting thing, at least I should have this done before Christmas.(Crosses Fingers)

Are you having your surgery done here in the Little Rock area?

No I am in Washington State. Way accross the country from you. I am on preop diet currently and I am slowly losing weight, so I believe that I will meet and exceed my doctors mandate by the 28th. Then the real work begins... Good luck.

Hi! I am new...newer than you! I have my consult may 30th. I also have bcbsil. I have sleep apnea and asthma though so I am hoping that will help speed things along...although I want to tell someone about the voices in MY head too!! lol

Here's a bit about me:

I am 41, mother of 6, happily married, stay at home mom I live near Bloomington, IL

Nice to know ya!!

Stacy

Hello, I am just starting the process as well! I am going to an appointment next Friday, May 22nd. They are going to take my picture then too. I am nervous, scared, and reading some of these postings have me shakin' in my boots. Best of luck to all of us who truly want to change out lives!! I am Lori from Iowa by the way. :thumbup:

Well welcome Lori and Stacy!! I can understand the nervouness!! I am right there with you! I am so ready for this tho. I have never been so sure about something in my life.

A little About me. Im a 43 year young, happily married Mother of two. I have a 26 year old and a 7 year old. (I know - I thought I was immune!!). I live in Arkansas and am Originally from Canada.

Have you all started some kind of weight loss program yet. Something to kick statt this all? I am trying to get myself regulated on 1500 calories a day...Its been a challenge for me this week. I just got my Visitor so I want chocolate Dang it!! lol

My insurance flat out refuses to pay --- So I am a self pay patient .. Ihave had to do the psych eval and nutrition consultation -- all out of my pocket . So that was $300 spent this past week. I will see the surgeon June 22 to set appointment for surgery.

Doesnt it suck that the insurance companies are being so hard on some of us? I mean, do they think that this is all a joke? I often wonder what the person thinks when they see someone like me on their desk who has a history of being overweight MORBIDLY OBESE as they say for just about all of my life, and then they are like no..we dont have the proof that you have tried to lose eight before...Get real!

Sorry It just irks me to no end. Along with having to go through the hoops and loops that they send us through, do they for one minute not realize that this is our life that we are dealing with?From what I seen last year in what the Company alone pays for my benefits..the surgery was paid for about 3 years ago..lol

<end of rant now>

:confused:

Our insurance does not seem to understand "morbidly "obese.. I am type 2 diabetic, mobility impaired and afraid I will die if I cannot get my weight under control.. we are foregoing vacations ,wedding and graduations to pay for this surgery. For what they could save on medication alone -- you think they woould be glad we are willing to undertake this surgery and lifestyle change .. I take 5 medications a day -- at the end of the month that totals almost $500 that insurance has to pay , with our co-pay we are spending $200 a month.

If I-- WHEN I lose the weight I am hoping to get off of diabetes meds, depression meds, cholesterol(maybe) and

that bring me down to only 2 pills a day .

I am in AR also.. But I am quite a bit older -- I am 61 .

I too am soooo ready for this .. I want to shop in the "regular" sizes and I wnt to be avle to walk more that 1/4 of a block before I feel like passing out from pain.

I am so with you girl. I heard from My surgeons office today and the insurance wants more information. I think I am going to write them a letter and let them know what it is like to be me. The difficulties in walking, and shopping and everything else!! I wonder if they can even fathom what it is like to walk a mile in our bodies..lol

So you are in Arkansas..what part? A few of us are here actually some with the surgery and some of us waiting.

I am sorry that you have to go through the self pay mode. did you not appeal the decision? If my insurance company even thinks about denying me..I am going to appeal them to high heaven..lol I ahve already written a letter just waiting to hear back from them about what they want. The letter got to my docs office today and I am hoping it is waiting for me at home so I can fax them some information!

Sometimes I think that being nice gets you no where and I hate having to resort to being.Ermm..Forceful? lol But it is not above me..lol

The biggest problem is -- on one of the first 3 pages in our "INSURANCE HANDBOOK' In bold latters-- We DO NOT pay for any kind of weight loss programs" - BUT they do pay for penil implants for me .. WTF -- Where is the justice ???

2 years a go I tried the UAMS liquid weight loss diet -- the min. I got off the liquid , I gain the 30#'s back PLUS another 13#. That was also out of pocket.. $75 a week for food supplements,, $100 every toher week for lab work, time involved getting to UAMS -- PARKING for a fee - waddling 3 blocks to the building only to find out they have changed the class room location AGAIN - waddle another 2 block to the class- sit on small wobbly metal chairs that are to small for ANYBODY over 150# and I had that plus an additional 85#.

I am in Little Rock area -- Am having my surgery done in Texas-- Prices are better and the office staff is MUCH friendlier that the ones I spoke with here.

So they consider Surgery a program? I would ask them to define what a program is and how they feel that surgery is a "program". My insurance company told me that they do not cover those kinds of things also..but they said that would be like, Jenny Craig, Or Weight Watchers..those kind of things, which would make sense to me. that is just not right in any regard. Remind me to never accept your insurance. I have BCBS of IL with my work, and they are being decent. Friendly and telling me how to get the info that they need. The customer support staff are really nice and telling me little *clues* on what I need..lol it is very amazing! I cannot for the life on me tho see how an insurance company can see a person who is more than 100 lbs over weight and KNOW that they have health issues and not approve the surgery. If it was something that people were doing for cosmetic reasons, then yes..I can see that. Insurance should be for medical necessity...Cosmetic should be the persons dime. Dont you agree?

I hope that is goes well for you in the mean time..when do you have surgery? You will have to let me know how it goes and how you are feeling.

Just got out the handy dandy "Book" again.. It states

WEIGHT CONTROL: Medications prescribed,dispensed or used in anyprogram of weight control, weight reduction,weight loss or other dietary control are not covered. Weight loss procedures, including complications relating thereto, are not covered.

Such a fine program --NOT !!!

That is just plain HORRIBLE! I cant belive that they went and got into the itty bitty details. Shame on them!! However they sound like my hubbys insurance - Qual Choice..they dont cover Dink!