Nervous about my insurance giving me a rough time over Lap Band surgery....

Amber K.
on 12/4/14 5:28 am

So I've started going through the initial stages for lap band surgery but I am so nervous my insurance company will deny me. My BMI was 40.1 (I’m about 120 lbs over my ideal weight for my height), suffer from ankle pain, and I have high blood pressure that causes really bad migraines. The dietician, psychologist and physician all three said I'd be a good candidate and that I'll require little behavioral modification since I'm constantly on a strict eating habit and I'm relatively active.

My paperwork is being submitted as soon as they receive the write up from the psychologist (should be before December 18th). BUT ... I am so nervous my insurance company will deny me for some stupid reason. My insurance is Blue Cross Blue Shield of Illinois, their requirement is :

  • You are 100 pounds or more above ideal weight, or
  • You have a Body Mass Index above 40, or
  • You have a Body mass Index of 35 or greater and suffer from medical problems associated with obesity such as coronary heart disease, type 2 diabetes, sleep apnea or hypertension.
  • You have been overweight for at least five years, and
  • You have failed all weight-loss attempts including diets, exercise and weight loss programs.

Anyone else deal with Blue Cross Blue Shield of Illinois? Good/bad experiences?

Amber K.
on 12/4/14 5:33 am

The very last bullet point has me extremely nervous. Every doctor (both Family Dr. and my OB GYN)  visit we spoke about what I was doing to lose weight but I don't know if thats enough. The clinic seemed confident I met all the requirements but I am not coping well with the fear that I could get denied :(

Vivian Prouty
on 12/4/14 8:40 pm - Fort Worth, TX

Amber.....seriously don't stress out over this until you have a reason to stress out.    At this time of the year there is enough stress going around for everyone.    Sounds like to me that you DO meet the requirements.    BTW.....High blood pressure is a co-morbidity as well or at least I'm pretty sure.    Just sit back and be positive that you will be accepted.    If not then you work with your surgeons's office.  They know how to get the surgeries approved.   Praying for peace in your life now.

 

Hugs and blessings ~~~ Vivian

GOD GRANT ME THE SERENITY TO ACCEPT THE THINGS I CAN NOT CHANGE;   COURAGE TO CHANGE THE THINGS THAT I CAN;  AND THE WISDOM TO KNOW THE DIFFERENCE !!!!    THIS IS MY DAILY PRAYER.
Vivian Prouty      Obesity Help Support Group Coach  "LOSE IT 4 LIFE"


 

Gwen M.
on 12/5/14 3:37 am
VSG on 03/13/14

There's a saying -- “Worry is like a rocking chair: it gives you something to do but never gets you anywhere”

:)

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

pineview01
on 12/8/14 11:41 am - Davison, MI

Looks like you met their goals for you.

BAND REMOVED 9-4-12-fought insurance to get sleeve and won! Sleeved 1/22/13! Five years out and trying to get that last 15 pounds back off.

Amber K.
on 12/23/14 1:21 am

YAY My insurance company received all the information yesterday and I got the call today that I am approved. I'm so excited I could burst! ^_^ What an awesome gift. Any advice for preparing for surgery would be extremely welcomed!

Iam_with_the_Band
on 12/24/14 11:24 am

I don't know what your surgeon has told you, but as a person who works in the industry and also one who had LapBand, I have heard a lot of surgeons not doing the Band and if they do, they warn the patient that its' a temporary measure.  Go in with the mindset that it may be temporary.  Learn everything you can from eating healthy and smaller portions.  Max out your golden year.  That first year is when you can lose the most weight and learn the most.  I lost 271 lbs in 22 months.  I lost my first 100 in 4 months.  Don't cheat on your surgeon's diet.  Follow it and follow it knowing that it will work the best in that first 6 months. There is no magic, hard work and really mindful eating.  Take advantage of your gift.

12/09 and 6/11, 9 skin removal procedures with Dr. Sauceda in Monterrey Mexico
Revised to the Sleeve after losing 271 lbs with the LapBand. 

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