Recent Posts

disney38
on 6/2/09 3:00 am - West Fargo, ND
Topic: RE: need information please
My BMI was 39 when I got denied for insurance coverage.  I had just been diagnosed with sleep apnea, and was borderline high BP and high cholesterol, but not on any medication.

I really thought that my being diagnosed with sleep apnea, that would turn the corner for insurance coverage, but it did not.

Here is what my insurance letter said to me:  I had sleep apnea that was controlled by CPAP, so they did not count that as a co-morbidity.

I dropped it for 8-9 months, but still was sleeping poorly and extremely tired, so I knew I wasn't tolerating the CPAP.  I went back to the sleep specialist, who wrote a letter to BCBS indicating that my sleep apnea was not controlled by CPAP, and that the best thing to cure the sleep apnea was to lose weight.  Within 2 weeks, I was approved for surgery.

I guess I would just tell you not to give up.  Insurance companies want people to go away, and not fight.  Keep on fighting....and good luck to you.

Lori

248/137/140
Lap RNY 7/2/07

To the world you are just one person, but to one person you are the world. 

Lisey
on 5/31/09 12:08 pm - Milwaukee suburb, WI
Topic: RE: Lets take a poll....

Lets meet in Hillsboro then.  I would rather just eat at the bar.  I'm eating high protein, low carb at this point, so a meat dish just wouldn't do very well in a park (cold meat, icky!)  I'll PM you with my #.  I'm looking forward to meeting you, Kelly!

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

tinkerbell025
on 5/31/09 11:47 am - Fargo, ND
Topic: RE: Lets take a poll....
No family that direction. My family is in the cities, St Cloud and Wisc.
There is a town between you and me called "Hillsboro". I know they at least have a bar/VFW, I believe they cook food too. I am guessing that is approx 35 to 40 miles from here,so that would be about half way. Or we could find a park! and each bring a WLS friendly dish to share?? Give it some thought.
Kelly/tink
Maintaining! Start weight 257,Current weight 122,Loss of 135# and 114 inches,Size 22-24W now size 4 to 0 (zero),Healthy life=Priceless

www.onetruemedia.com/shared
Lisey
on 5/31/09 7:27 am - Milwaukee suburb, WI
Topic: RE: Lets take a poll....
I live in GF & now that I'm officially unemployed, I've got lots of time too!  Did I tell you that my first day back after surgery was when I was told that I no longer had a job?  Nice, hey???  Too bad there's nothing in b/w us that we could meet up half-way.  Short of a luncheon at a Wayside, I just don't see that one happening (yuck!).  Are you planning on coming up to GF during your vacation?  Any family up here? 

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

tinkerbell025
on 5/31/09 6:15 am - Fargo, ND
Topic: RE: Lets take a poll....
Well hells bells... How far are you from Fargo and what are your plans before moving, besides packing etc.. lol. WE could at least get together for something! I am off work for the next two weeks!
Kelly/tink
Maintaining! Start weight 257,Current weight 122,Loss of 135# and 114 inches,Size 22-24W now size 4 to 0 (zero),Healthy life=Priceless

www.onetruemedia.com/shared
Lisey
on 5/31/09 1:27 am - Milwaukee suburb, WI
Topic: RE: Lets take a poll....
Hi Kelly!

Actually I brought it up a few weeks ago when I got back to work after surgery only to be told my job was being eliminated, which prompted me to decide to move back to WI.  That's when I chimed in about us possibly getting together.  In any case, I am moving in 1.5 weeks, so I won't be able to make it 

I'm very happy to be moving back to where all of my family & friends are, though!

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

tinkerbell025
on 5/30/09 11:10 pm - Fargo, ND
Topic: Lets take a poll....
I know many people have responded to having the ND gathering. Thinks this was Jewels (?) Idea.I think the next step would/should be to set a date!!

I will HELP with some of the planning,if others could join in, that would be wonderful!

Where would be a good location, kind of central for all wanting to join?

Would we want to do it in a park?

Pot luck/picnic, bring those friendly dishes?

Give me some idea's.

Kelly/tink
Maintaining! Start weight 257,Current weight 122,Loss of 135# and 114 inches,Size 22-24W now size 4 to 0 (zero),Healthy life=Priceless

www.onetruemedia.com/shared
Judi J.
on 5/29/09 1:25 am - MN
Topic: RE: need information please

ditto what Lisey said, you need to find out specifically why you were denied. Sometimes it is simply a matter of more paperwork.

My weight was way over the 40 bmi but the insurance person at my doctor's office still wanted to document any comorbid I had, she said it all helped. So we tested me for sleep apnea and sure enough I had it

let us know what you find out and good luck!

littlewoman
on 5/28/09 3:28 am
Topic: RE: ND Gathering??

Hi!

I live in Williston also and am going to have the gastric sleeve done on June 10th.  I am scared now because it is getting closer to the date and then my husband says he is against it.  He doesn't understand that when all of the after surgery liquid diet, pureed diet is over I can have regular food, but only smaller portions, and no fatty or sugary foods.  I am okay with this because I don't like fatty foods anyway.  The only sugary food I have to give up is my licorice.  I do like cookies, but I can sacrifice them.

I have message me here at my account to reach me..

I am needing a little support.  Do you know of anyone else who has had the sleeve done?

Thank You!

Lisey
on 5/27/09 12:57 pm - Milwaukee suburb, WI
Topic: RE: need information please
A lot of people win on appeal, so don't lose hope & I think it's worth the effort.  I self-paid in Mexico b/c I had a duodenal switch & they simply do NOT cover it for anyone.  What did your denial letter specify as the reason for denial?  It might be b/c you haven't been attempting to control it through medication.  Don't take my word for gospel, though.  My thoughts?  Fight for yourself!  I know it's a time & emotional investment with ups & downs, but it's worth it.  If your appeal is denied, you can appeal the denied appeal using an independent third party.  I know of people on the DS forum who have won this way, so it is a possibility.

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

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