I'm so depressed...

Well I found out today that my employer does not have a self funded insurance plan. We are fully insured, therefore, BCBS calls the shots and they say, NO SURGERY ALLOWED. Who made them GOD? Therefore, there is no way around the exemption (or so they make me believe). I am so depressed now. I have been crying, eating, sleeping, fighting with my husband (because I am irritable and upset) and then crying, eating and sleeping some more ever since I got the news. What a viscious cycle. This is just so unfair. I feel like I am trapped and will continue to be trapped inside this body forever. I am sorry to sound so negative but I just needed to vent and figured y'all would understand. My husband (God Bless him, just doesn't seem to understand what I am feeling and although he trys to help, the things he says just upsets me more-like dieting and exercising because we all know that losing 200 lbs is sooo easy right? ) says I should keep fighting and that somehow we will figure out a way for me to have this surgery. If only it were that simple... Well, I'm gonna go for now or else I will just keep rambling on and on. Thanks for listening and God Bless. Tammy W. BMI 64.9

Dear Tammy: Don't give up yet..... I can't tell you what my outcome is yet as I am still waiting, but I have the same problem with the small group/large group issue. We have sent an appeal asking them to please look at the medical necessity and charging that they are discriminating against me in two ways: 1st because of the fact that I work for a small company, when they would cover if I worked for a bigger company, and 2nd discrimination against the disabled, because due to the co-mobidities, that are caused by the weight, I am substantially disabled according to the American's with disabilities act. My exclusion is also worded in a confusing way and does not mention surgery at all, so we are hitting that point first. I think that you need to fight as far as you can, even if it means going to the state insurance board. Also let them know that you intend to fight all the way to the governor's office if need be.......sometines just letting them know that you are not going to disappear can turn the tables in your favor. Good luck! Dawn

Dear Dawn, Thank you so much for responding to my post with your words of encouragement, it really meant a lot to me. I am sorry it has taken me so long to reply but I have had a lot going on. Good luck to you also and keep fighting. Don't let them win. I don't know what state you live in, but try researching your state laws and statutes. I just found out (by researching my states's general assembly website) that they passed a new law to take effect in January 2006 which will require all ins co's to cover WLS baseed on the NIH guidelines! Kool huh? So, the laws are changing all the time. Check the laws for your state and keep fighting!!! Take care, Tammy

Donna hugging Tammy close Sweetheart I understand your upset and angry. Been there and done that. You want to kick the sh$@ out of everyone and scream, cry while your doing it. You turn to food for comfort because you feel that food is what's killing you so let's make it a quick death. Have you emailed Gary and asked him what he thinks? Is there anyway you can get a job so you can get your own insurance? Before giving up and fighting with your husband all the time really looking into this because I was told by someone in my Husbands company that his Company don't cover WLS anymore. Stopped covering it back in 2001. HELLO!! I had my surgery. If I had listened to her I would not have my surgery today. My husband was the same way with me. Just diet and walk and the weight will come off They don't understand because they don't walk in our shoes. Donna 338/229 -109

Dear Donna, Thank you so much for your kind words of encouragement. It meant so much to me in my time of need. I do not plan on giving up. I will have WLS one way or another! I have been researching the web and just came across some info tonight from my state's General Assembly's website, that my state passed a law to take effect 1/1/06, that all ins co's must cover WLS based on the NIH guidelines on obesity! Isn't that wonderful?!?!?!? I am sooo happy!!! Boy oh boy, what an emotional rollercoaster I've been on lately! lol Anyways, I just wanted to say thank you for caring because it's the people on this board that keep me sane throughout this process!!! Btw, CONGRATS on your weight loss!!! Sincerely, Tammy

We are all out here to give each other comfort and encouragement and I'm so happy that some States are finally wising up and passing the law to save lifes. Donna 338/227 -111

Dear Tam, I know how your feeling right now, I was denied the day before my surgery because my insurance was being terminated the day after so the insurance company didn't feel the need for paying for this, So can you imagine how upset I was with all of the testing and the running around I was doing.... But don't get discourage or give up everything will be okay, just look at other options like getting medicaid to help pay for it... My prayers are with you hun Mellie

Dear Mellie, Thank u so much for responding to my post. It really meant a lot to me to know that people were thinking about me and praying for me. It's all the nice folks like u on this board that keep me going! Thanks again!!! I did some research on my state's laws and found that they have passed a new law to take effect on 1/1/06 that will require ins co's to cover WLS based on the NIH guidelines! So, don't get discouraged. Do some checking on your state laws too. Keep fighting. Take care and God bless you on your journey. Feel free to email me anytime. Sincerely, Tammy