Preferred One ins for under 40 BMI ......help!

Judith G.
on 11/8/05 7:59 am - Twin Cities, , MN
I meet with Dr Lederer tomorrow for my first appointment. Preferred One faxed me the criteria I need to meet (in order for them to pay 75% after my $3500 deductible)......I had spoke to an ins rep on the phone earlier and thought I would quailfy but now that I got the fax I am afraid that I won't and I am freaking out (just a bit) because I have really convinced myself that the laproscopy Lap-Band was THE answer to my prayers. I figure that I am at about 37 BMI (5'3" 210 lbs). I have high cholesterol and often have heartburn (but no GERD diagnoisis). I don't have sleep apnea or high blood pressure. I do have neck/back pain that causes headaches. Anyway...the insurance criteria that I wasn't told about until today is that if my BMI is between 35 & 40 I need BOTH: 1. failure to lose weight or maintain weight loss after documented regular participation for at least 1 year in a physician invovled weight loss plan including diet, exercise, behavior mod & pharmacological mgmt. ...my DR did prescribe a drug to help lose weight but I don't have 1 year of regular participation in ANYTHING!! The Phen/fen drug I took was a long time ago. A little over a year my current DR gave me a prescription for phentromine(sp?) but didn't really monitor my weight changes. 2. Failure to lose weight or maintain weight loss after regular participation in more than one weight lose program. My DR appt is tomorrow ......what am I going to do????? I did do South Beach Diet in May 2004 (not within the past year) for awhile ...but how can I prove it since I did it on my own? I have some fitday.com weight charts that I tracked my progress on for awhile--should I bring those? Other suggestions? Judith
CuteDonna
on 11/13/05 12:15 am - Effort, PA
Call the insurance company and tell them what you have and ask them if that will be enough. I had to go to my PCP every month and have it documented as all the other diets I tried on my own where worthless. Donna
Most Active
×