what if BMI drops

ColleenChristophKant
z

on 3/24/10 12:11 am
I really think you should look into other center.  I think Forest Hill was great.  There has to be a way for you to get the surgury done.  Ask questions from other places.  Sorry to sound so pushy.
marjane67
on 3/24/10 12:44 am

I don't think you're pushy.  Unfortunately php mid michigan only works with sparrow unless you have special cir****tances to go outside of network.

From what I'm told, my insurance will not accept my 7 months of weigh****chers - so I would have to do a 12 week medically supervised plan before they would approve me.  My bmi could not drop - because they would deem surgery as no longer medically necessary if I fall under the required 40 bmi. 

The language on my insurance guidelines tells a different story:

It says "documented compliance with weight loss program including diet, exercise and behavioral modification for a maximum of one year.
OR
completion of a 12 week medically supervised weight management program provided by a network which will be covered."

I think its bogus not to accept weigh****chers because the weekly classes encompass all 3 of those things, and it does not say medically supervised.  SWL is going to submit for me; but even with all that, i'm told its likely I will not be covered.  I will then try to appeal, but don't have the funds for obesity law or anyone to represent me so I feel like it's never going to happen. 

I have looked into self pay at harper in Detroit; they will take a payment plan. But if something happened down the road insurance wouldnt cover it and it would financially destroy me.

It's a big fat bummer!

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