need help being optimistic

Hello all, I had my first appointment with the surgeon yesterday and I am a little disheartened by the fact that empire government plan- united healthcare requires 6 month weigh ins and are typically tough on approvals. my bmi is 47 and I have no comorbities, atleast none that are listed as main side effects of obesity.  I am a chronic insomniac; i feel that weight loss will bring me back to normalcy and give me the energy to excersize and try and beat this theif of sleep.

I am really bummed because I am not sure what they are looking for on the 6 month weigh ins, I just want to ensure approval.

Dear Py,
I'm not sure if I'm the most versed in this but I will say I started out with state insurance for Illinois; Unicare.  Then I switched to the other plan we had available which is CIGNA. I went to my doctor for the 6 months supervised visiits for weigh-ins and diet counseling from my physician. Read the policy very carefully, some of them if you have a high BMI, you don't need a list of co-morbidties and I think if you are having trouble sleeping, you may have sleep apnea and that is definitely a considerable factor. 

ONce I completed my 6 months I did my Psych appointment and my surgeon  submitted my paerwork. (Stay on this site, they helped me a lot and....read the guidelines carefully with the reguirements you need.The insurance coordinator at the surgeons office also guided me in what to do.) after that, I put my paperwork in, they denied it. We sent in an appeal and they approvied it a week later.  You can do everything by the book and these insurance companies may just deny it for the "*** and grins of it. Get started and stay focused. Keep your eye on the prize.

My surgery is scheduled for 10 days away.  IT was a tedious process, but it all worked out in the end. God Bless,
Contact me anytime.

thanks a bunch. I will keep you in my prayers.  My issue is w/ this 6 month weigh in. obviously if a obese person decides that the last resort is surgery, then why the 6  month weigh in. so best case is you loose 20-30 pounds, is that too much? or if you dont loose, what else is stated in the notes that make the correct argument that the person is a candidate.

Even though we "decide" we want to do this, the insurance company is paying so they feel like they have the last word.  They send you through all of  this to make sure you can't lose weight by any other means. I didn't lose a lot of weight on that 6 month weigh in. I month up 6, next month down 3, next month down 12, up 2 etc. 

They put the diet plan they suggested for you, your BMI, any other things that are wrong with you, (your sleeping habits) etc. Make sure they document everything; knees, legs, breathing etc. You never know what's affecting you or what your surgeon may be able to use to further your case.  I had osteoarthritis in both knees and borderline high blood pressure. Most importantly, make sure you get a PCP that's on your side.

If you get one that doesn't believe in WLS thats your key to find another primary doctor. the six months will fly by.  Also, believe it or not, this gives you time to make sure this is what you want to do, research - talk to others that have done it etc.
cc

Chile - anything you put your mind to and FIGHT for - you shall HAVE!!!!!

I went through approval with CIGNA - took me 8 months and THREE times at the denial/appeal table to get them to unazz my approval - you just gotta set your mind to stay the course and don't let them and their bullshiot get to you.  If you WANT it - then you will HAVE it!!!! 

It took me 4 years, 6 denials, 3 insurance companies, 2 states, 2 iron infusion and......1 approval. 

Do what is required. Stay in constant contact with your surgeons office and your insurance company. Bug the hell out of them. I'm not sure if they are looking for you to lose a certain amount of weight. I think they want you to try to lose the weight on your own. I would call them and ask. Call back several times to make sure they all have the same answer.      

Good luck on your journey

tricie