Insurance Rant for the Week! Yay!

New Hurdle for this Week...Excellent!

Well, I'm moving forward despite finding out last week that my insurance requires a BMI of 50 before it will cover the DS.  I must go through the motions of the 6-month diet and psych. eval. only to be greeted with a Denial, Ho! Ho! Freakin' Ho!, as a Christmas gift in Dec. when everything's submitted by the surgeon's office.  So, I already know I'm staring an appeal in the face.  I know this.  I accept and will move forward accordingly when my Denial arrives.  Ooooooo, I just pictured Chevy Chase in National Lampoon's Christmas Vacation.

Back on track...the Insurance Co-ordinator from the surgeon's office I'm considering calls this afternoon and tells me that my insurance company has its own "separate" requirements that are outside of and in spite of my employer's policy with them--that all insurance companies have their own requirements besides the ones in MY POLICY! Absurd! 

So now they've snuck that dreaded 5-year weight history in on me as one of their own requirements.  Hello! I've been fat since I was 9, has my BMI consistently been at 40? NOOOOOOOO! Will my 5-year weight history reflect a BMI of less than 40 at some point during those 5 years? YESSSSSSSSSSSS.  Pardon me while I barf.  Guess I'm supposed to wait until I'm older, sicker, fatter and actually a full blown diabetic in order to satisfy some 5-year weight history crap criteria.  I think I'll get my quadruple bypass paid for, cause I'm gonna need it, before I get the DS!

These little mountains keep growing...well, guess what, I've got a Pogo Stick from hell so your mountains can suck on my rubber heel as I'm bouncing over your ass.

I know this must be hard but this is just a little hurdle...Just stick to your guns and everything will be okay. This is just an obstacle..and I'm sure your strong enough to overcome it.

Thanks, Miss Oreo! I'm just constantly in attack mode when it comes to the DS and insurance.  It's like I'm a momma Bear on patrol ready to defend her DS cub.  I am going to have a heart attack if I don't calm down and stop takin' this stuff personally; for the Insurance Company, it's business as usual, for me, it's my life. Blah. Blah. Blah. Have a good weekend!

HAHA Des, you're a HOOT! Vent all you want baby...the dread insurance co sucks butt so we all feel ya! im not to insurance approval yet but i have spoken to my insurance and they tell me and my surgeons office that WLS is covered just as long as its medically necessary and that they dont have packet to send me...ive called 3 times. So i guess if they decide to screw me over i have nothing to fall back on!

Keep your eye on the prize:)

I'm just getting started and no where near submitting for insurance approval even though I've already been informed that without a BMI of 50 for the DS, I will most likely be denied on that point alone, aside from the 5-year weight history and whatever else they through in my path at random.  I know bypass surgery HAS to cost more than the DS, what do you bet? (:  Good luck to you! Keep YOUR eye on the prize (:

These little mountains keep growing...well, guess what, I've got a Pogo Stick from hell so your mountains can suck on my rubber heel as I'm bouncing over your ass.

Great visual!  I'll use it in other situations I'm sure!

Glad I could help, k9! (:

 hehehe LOVE that "pogo stick from hell".....I feel ya darlin'.  I'm trying to figure out how to do all the diets I've been on in PREP for the insurance war.  I never had money to do Jenny Craig and all that crap.   What a joke to have to get worse, before they want to do anything.....such a load of bull....Of course, when you get to my size and age and you HAVE full blown diabetes and high blood pressure and all the weight related problems, the surgery will be more dangerous and MORE expensive because of all the precautions that need to be taken.  Grrrrrrrrrrr...hang in there and give 'em hell......

That is THE BEST thing about this board, is all of the AWSOME positivity & the wealth of information!!! 

Just keep your eye on that PRIZE!!!!!



You & I will get there, eventually!!!!!
-Jamie

It's like they say, "Sure you can have weight loss surgery" and then turn around behind your back and say, "Not really though. Let's just mess with her for a while."

Evil.