Hi Everyone!!

I just recently completed my 6 month program. I saw my surgeon on Tuesday and apparently, I lost too much weight. In his professional opinion, I can do it on my own. I'm a bit frustrated and confused. Has anyone else had this problem? I am afraid the insurance company will not approve me, even though they are supposed to go by your starting weight and BMI. I have BCBS PPO.

I am from NY and we think differently. I do apoligize but pray that you get the surgery.

No worries!! Thanks for the prayers!! :wub:

umystifyme, just a suggestion- write down all the real attempts you have made to lose weight- don't rely on the doctor's records. You may have had the records transferred but have had many doctors in your attempts. it will help.

Well... I talked to the program coordinator for the bariatric program that I went through and she will be submitting my documents to the insurance company for approval tomorrow. I asked her what she thought.... she said she has never been in this position before, as she has never seen a patient lose this much weight in the program. She said it is BCBS's policy to go by the patient's initial weight and BMI and that is how she is submitting it. All I can do right now is hope and pray. I'll feel much better once it is approved. I hope it doesn't take too long to hear back from them.

Thanks for all the lovely comments and words of encouragement. It really helped me through a weekend when I was totally freaking out!

Amy

I have NY BCBS and she is right they go on the original weight before the loss. You doctor can call them and fight for you.

Do NOT freak out..the worst that can happen is they deny you.then the doctors can fight for you,

NY BCBS needs you to have the urgery they save on your meds if you are denied,

In your case only Donald Trump can say ...DENIED!!

Keep us posted

Laura

I have NY BCBS and she is right they go on the original weight before the loss. You doctor can call them and fight for you.

Do NOT freak out..the worst that can happen is they deny you.then the doctors can fight for you,

NY BCBS needs you to have the urgery they save on your meds if you are denied,

In your case only Donald Trump can say ...DENIED!!

Keep us posted :biggrin:

Laura

I hope it doesn't get to the point that I have to fight for it but if it does, I hope my doctor would call and do that for me. My hope right now is that I will be approved. I have to call my doctor's office tomorrow and find out how long it usually takes to hear back from BCBS of MI. I'm stressing a bit....

Thanks for your support and I will keep you all updated!!

THEY fight for you..they want the money....and in NY they do repeat...do fight...

I just found out that the insurance I had that time..would have given me a visiting nurse....so just relax.

they will find a way

laura

Go to another doctor. That may be his opinion, get a second opion and tell the doctor that you already went through the 6 month program and that you do not want to be a victim of the yo-yo syndrom again.

Good luck !

Go to another doctor. That may be his opinion, get a second opion and tell the doctor that you already went through the 6 month program and that you do not want to be a victim of the yo-yo syndrom again.

Good luck !

That's exactly my next step. I contacted a surgeon that I saw last year. So, if this isn't approved and he won't fight for me, then I will have to go see her and see what she will do for me.

Thanks!

I am 5'4" and my starting weight was 285. I am now 203. I lost 82 pounds in 6 months with diet and exercise. I'm afraid my insurance company will not approve the surgery because of my massive weight loss.

that i s greta. i could not lose any weight and was trying everythinkg. i even gained after my start weight. i was afraid the ins was not going to approve me. i have amerihealth. i was on steriods an dhad been sick for 3 months good luck with the band and ins. i am sure u will do fine

:frown:

I have finally decided to look into bariatric surgery....I weighed 296 in 1998; went to a weight loss clinic and lost 120 lbs, but within two years it all came back on....I have tried and tried since then, but currently weight my all-time high of 325. I am scareed about the powerlessness I feel the last six months..have never ever felt this out of control..and completely unable to curb my appetite.

I am so heavy (5"8") and BMI of 49. the doctor won't give me diet pills anymore because it could hurt my heart. I am 63 and am pretty resigned to Water aerobics and that's about all I can do...the rest of the day on the computer...no social life left at all. husband quietly enraged, but loves me and is very good in spite of his anger at me. he understands but it still makes him angry that I cannot get more "willpower." He smokes. so he understands how hard it is. BUt I want to do this because I truly no longer am the same person I was even 50 lbs ago...cannot walk very well, etc. tired easily.

I have finally decided to look into bariatric surgery.......................

Seriah-

I have gone through the clinics and lost the weight and gained it back, been to all the mountains and back. REad my blog even with all the troubles (family) this year..I still lost weight. I am the biggest fan of the lapband and please write me a personal message and I can ease your fears.. I am 54 and this is the greatest.

I help support groups when they call me because Ms. Fearful finds this sssssssssoooooooo easy and just really happy.

The reason I am asking you to communicate off the boards you will need to find a surgeon who you can communicate with. Mine, for the first time in my life listens to ME and understands. I am not the quickest loser because I have bad asthma that prevents me from doing hard exercises and ugh..to some things..lol..age...but I see a really wonderful healthier body.

Please private message...go into my profile and this way it is easier.

Glad you found this page

Laura

PS....It took me close to 5 years to have lapband due to fear and if I had gone into a caring doctor..I would have done it..but all we went to was crooks...who new about this site ... also family friend had it done but listened to DH who said you can do it..well I CAN NOT ..that is why lapband rules...:frown:

Edited September 1, 200916 yr by jollygreen1955

Well... I talked to the program coordinator for the bariatric program that I went through and she will be submitting my documents to the insurance company for approval tomorrow. I asked her what she thought.... she said she has never been in this position before, as she has never seen a patient lose this much weight in the program. She said it is BCBS's policy to go by the patient's initial weight and BMI and that is how she is submitting it. All I can do right now is hope and pray. I'll feel much better once it is approved. I hope it doesn't take too long to hear back from them.

Thanks for all the lovely comments and words of encouragement. It really helped me through a weekend when I was totally freaking out!

Amy

I have BCBS of Maine, they approved me very quickly. Hope you get good news soon!

My doctor's office mailed my documents to BCBS for pre-determination today. I am confused about this whole pre-determination process. Is this when they either approve me or deny me for the procedure? I'm stressing... I will feel better once I understand this whole process. I will feel even better once they stamp approval on my form!!!

Yes, BCBS will then send your surgeon a pre approval letter which means you really "approved". With that letter the surgeon can get his money if the insurance company decides try and not pay him.... but thats another story.

BCBS easy approval... Yay

Yes, BCBS will then send your surgeon a pre approval letter which means you really "approved". With that letter the surgeon can get his money if the insurance company decides try and not pay him.... but thats another story.

BCBS easy approval... Yay

I'm keeping everything crossed!! Trying to stay positive even though I am quite impatient. The program director was unable to fax my documents to BCBS and I don't know why. And it took her 3 days to get them in the mail! :biggrin: I am sitting here biting my nails -- literally. But deep breaths..... I've come this far, so I HAVE to be patient!! I hope it is as easy as everyone says it is. She said I may have to wait between 14-28 days to hear anything from them! Okay... deep breaths AGAIN! lol

I was diagnosed with GERD so I hope that will help my case. I really appreciate all the positive feedback and support! Thank you!

Amy :tt1: