There's Still Hope For Me

I went for my first supervised diet plan program today and I received very, very good news. First, when I went last week to inquire about the supervised diet plan, I was told that my insurance would not pay for it and it would be an out of pocket expense. I told the office manager that I didn't mind paying for it. I was so ready to pay for today's session. When I signed in she told me it was a $10 copay and I was really surprised. I asked her if that was all I was paying and she said yes. If the inusurance doesn't pay for it, then I know I have to pay for it, but I'm willing. I told her I had two insurances, mine, which is Horizon BCBS PPO, and my husband's, which is BCBS PPO. They really made my day. When I initially started in this journey I was only using my insurance, not my husband's. When they submitted the request for my lap band surgery, my insurance denied it because they want 6 months of a supervised diet plan program. I was so frustrated, I gave up and tore up the letter that my insurance had mailed me. Well, today I was told that they're going to submit it through my husband's insurance, and that they're very good with approving the surgery without the required diet plan some other insurance companies ask for. I was, and still am, elated at the prospect of maybe having the surgery done in May. It's nothing definite yet, but there's a chance that it might be approved, but if not, I already went for my first supervised diet plan session. It was really fast and nothing to talk about. I was weighed and I lost one pound since the last time I was weighed. I was told to start eating proteins and have a 1200 calorie intake, exercise, and ween myself out of carbonated drinks. I asked the nurse what happens if I lose weight, will the insurance still pay for the surgery? She told me that many patients are worried about losing a couple of pounds because they think the insurance will deny paying for the surgery, but that's not correct. The insurance company just wants to see that the patient is trying and it will only deny the surgery if the BMI is 35 or less with no comorbidities. In my case, I have mild sleep apnea, high blood pressure, slightly high cholesterol and asthma. I'm good to go. She said I can lose some weight and still be approved. Nereida

Hi Nereida, I am so happy to hear that you may be able to have the surgery!!!  I will say a prayer that your husband's Insurance will approve you now.  Good-Luck,  and don't give up whatever the outcome may be.

Great news!  I'll keep good thoughts coming your way that you will hear about an approval quickly!

Glad you are starting the 6 mos diet - and if you don't need it, fine, but if you do, you have it started already.  Best of luck! Pam

I'm very excited, to say the least and I'm praying that it does get approved, but if it doesn't, then at least I have had started the supervised diet plan. My next appointment is for this Monday. Nereida