A little Nervous..

fitnfourties
on 9/6/09 9:05 am - Rochester, NH
I recieved my letter from the surgical center and they confirmed with me that my Insurance will cover the cost of my lap band however they sent me the guidelines I must meet and some of them seem ridiculous some are no brainers..like 5 years proof of being overweight, but the rest 6 months of notes from my doctor saying i was weighed and checked for 6 mths straight and proof of 2 failed  attempts of trying to lose weight on my own but acceptable attepts,what do they consider acceptable? It just seems like I have all the pre stuff to go through and then in the end may be turned down after all, I am nervous to pay out of pocket for therapy and so on only to get turned down in the end, has anyone else experienced this with their insurance company? should I be so nervous? I have harvard pilgrim health healthsource.
Thanks!
wen
on 9/7/09 8:04 pm - Manchester, NH
I had Harvard when I did mine and it sounds familiar.   I will say that they were awesome and approved mine right away when I did it.  I did not have the whole 6 months of being weighed thing..I know a lot of companies are doing that and I find it so silly...I mean if we could lose all the weight we need to in 6 months would we be doing this???   So..just start now if you have not.  By the time you get stuff going and room to be schedule 6 months will fly by.  If you have been to meetings and weighed in each time I think you can count that?

I did have to do the rest of that though.   If you have done any programs like Weigh****chers, Jenny Craig, Nutra-System, phen-phen, doctor prescribed diets...write down the years you did and approx how long and how much weight you loss and how long you kept it off.  It will be sketchy..I had to guess on mine.   If you went to any of the weight loss centers they may still have your stats..or if you have paperwork you kept.   I had to write mine down journal style but it was not a huge deal.  I dieted so much I was a pro.   The 5 years of being overweight can come in a note from your primary care or gyno..someone you have seen enough to have your weight record.   Do you have old pictures of you up and down...at your heaviest?  I photocopied some and added them to my notes.  Not sure if it helped but I did it anyway.

With the band they want to know that you are a person that at least tries to lose weight (some people have honestly never done a diet in their life).   It will take some committment on your part...just WAY easier than going it alone.

Hope that helped.
Jamie W.
on 9/8/09 2:00 am - Manchester, NH
I have HPHC and they were awesome. I was approved in 5 days with a BMI of 39. I had a complete physical w/my PCP in Jan. and he documented my weight. They actually weigh me every time I go there so they had a really good record of my weight for the past 5 years. My PCP also wrote an awesome letter of medical neccesity and I also wrote a letter on my own behalf explaining all the failed diets I have tried. Regarding the couselling, it's covered under your mental helth benefit so all you pay is your copay.
Good luck

Highest weight: 249
Date of Surgery Weight 7/20/2009 : 229
Jamie M.                
CABREB
on 9/29/09 10:57 am - Manchester, NH
HI Jaime,
How you doing?  I had my second adjustment today, and to be quite honest, I am hungry with just the clear liquids, oh well, we'll see what tomorrow brings.  I am finally settled in in school, and would love to go to a couple of meetings and meet you.  I don't have your email address.
Cathy=cabreb
~Cathy
Live, laugh, love

You are what you eat so I should eat a skinny person!!!

fitnfourties
on 9/8/09 11:12 am - Rochester, NH
Thanks for your words of advice and letting me know about your experiences I feel a little better about this now I am going to go ahead and follow all the rules I have been weighing in with my doctor regularly for almost a year now because I switched doctors last November however my records will show all my weight loss attempts and and how I have been overweight for some time now, I have lost weight twice and always gained it back, I have an appt. with my PCP Thursday and the I have an appt with Nancy Friday and I am looking forward to it! They have told me I have to lose 12 pounds before surgery so I have already started on this as well. I am looking forward to this journey and appreciate all your help! 
Thanks Again.
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