Major bump in the road!

Hello all... Most of you don't know me but I feel as though I know all of you... What a wonder group of people here. Coming here on the board and reading almost everyday such amazing stories has so inspired me.... Thank you all for sharing your stories :) Well Im jumping through the insurance hoops and I thought I was on the right trac****il yesterday... My Doctors office called and asked if she could fax me a check list of what the medical is requiring for my consult with a surgeon. I  have High Blood Pressure (on two meds)and  pre-diabetic ( no meds yet),  I am almost in constant pain in my legs and feet,  BMI is 54 and believe it or not, Im not going to meet the criteria that they are requesting.... How can that be??? I'm trying so hard to be positive and not give up but I've got to say.. I just don't know what else to do.. I know this surgery is the tool that I need soooo desperately. I've wanted it for years but keep coming across these "bumps"  ... Is it a sign ?? Maybe this is not for me?? Oh gosh, How can I not be in tears ....   Anyhow, I'm hoping someone can advice me what to do next.... I have Aetna HMO..  I need to get going to work.. I wish you all a very Happy, Healthy and Pleasant day !! Kellie

What the heck are their criteria? You sound like a perfect case to me!

I don't know anything about Aetna, so no advice from me, but I wanted to say welcome to board and don't give up! If you want it and are willing to work for it I know you will find a way to have this surgery, no matter what they try to toss in your path!

Keep us posted!


Shells

Thanks Shells for the warm welcome and the encourging words !! Kellie

Hang in there Kellie, I'm sure it's just a minor glitch and you will get it straightened out in no time.  Sue

Sue... Thanks for your positive attitude :)

Don't give up hope.  I know of many people who traveled to foerign lands to have their procedures performed and they're all doing quite well.  Thier hospitals and medical clinics may not measure up to that of what you see in American surgical facilities, but they're clean, their doctors attended med school and their surgeons are about as proficient as the so-called American doctors who tout themselves as pioneers in the field. I don't know about insurance coverage, but the operations are a lot cheaper than they are in the US.  For instance, I'm a disabled vet who used to be morbidly obese.  I was too heavy to move around comfortably, much less engage in any strenuous exercise.  Since I'm 100 percent disabled, I get Medicare, but most doctors I ran into refused to accept Medicare, so I had to pay out of pocket. Unfortunately, I selected a doctor more so on his slick presentation than researching him deeper than I did.  His surgical skills are great, but I find him to be a sleaze bag out for the big bucks and NOT an altruistic soul who would've cut me a price break for cash.  And I must have fallen through the cracks, because there were several times I should have received information, but didn't.  Perhaps Dr. Cirangle's office is too successful to return phone calls, I don't know. Good luck and keep pursuing your options.  Obesity is a problem for the ages.

Thank you for adding some options...  I wish you the best of luck with your situation as well...

Kellie-Don't give up keep on fighting for this.  Insurance companies make it so discouraging for those of us who need this so desperately in life.  When I started this I was at 310 lbs, had high blood pressure (only 1 med) high cholesteral (one med), my sugar level was going up although I had lost weight and some other medical problems with the nerves in my foot and in my back.  My insurance company didn't igve me clearance until 3 days before my surgery was scheduled, talk about waiting until the last minute! Work with your regular doctor as well as the surgeon, have all of the documentation, test results, psych exam and everything.  Stay on top of it all and stay in touch with the insurance company as well.  Talk with Monica who is also on the boards, she can help a lot after what she had to go through to get the surgery for herself, she can probably help a lot.  I wish you the best of luck,  Sharon

Sharon- Yes you are right, I had to learn the hard way to keep documentation of EVERYTHING .... and more importantly make sure that your Doctor Documents EVERYTHING.. Thank you for your support :)

I also had a problem in the past with my insurance for a different surgery so when open enrollment came around at work I switched to my other choice that happend to cover what I needed. Is this possibly an option for you?