Help. Very Depressed!

I have not had surgery and I've finally accepted the fact that I won't be approved by MMOH in time. I am one of the unlucky ones who will not be able to have surgery after July 1. My consult isn't even scheduled until May 28 and I do not have a 5-yr weight history (i had no insurance and never went to doctor) so I'm not kidding myself that everything will be fine and I'll get the WLS. BUT...now what? I am so depressed I can barely function. I cannot do self-pay. Is it back to ol' drawing board AGAIN? More Weigh****chers? More Adkins? More whatever diet I haven't done in a while? More of everything that failed before?! I will be this big forever, won't I? I am miserable. ~TB

I have MMO also and have been told that as long as your paper work is in MMO's system before July 1 you can appeal if they denie you. Becaus you started before the new policy takes effect. Start writing your own 5 year weight history. Get pictures, make copies, and have the doctor sent them allong with all the other paper work. Did you go for yearly pap test anywhere? If so they may have a record of your weight. Did you join Weigh****chers and have their cards? Or cancled checks from where you bought workout items?? Start thinking creatively. I wrote my own 5 year history. You can see it in my profile here. http://www.obesityhelp.com/morbidobesity/profile.phtml?N=W1055768721&NoStatic=1 Think Positive and Creatively. Good Luck, Robin W 11/17/03 218/146/120-115

Make sure your plan is one of the plans that is excluding WLS. I have Medical Mutual of Ohio SuperMed Plus with Acordia. They have not announced any new exclusions for WLS. My plan does not excluded it or is there aa 10k cap. I am still in the appeals process. i am waiting on them. If you need an appeals letter I have one. It can also be used as the letter you write to the insurance company with your dr documentation. Also MMOH will consider dated pictures, perscriptions, any weight loss group(WW etc) logs, canceled checks,OB GYN notes, personal diaries with history, weight journals. Make them pay... Bad Insurance COmpanies If you need help let me know.....

Hey Trish, All is not lost sweetie! I was in your boat yesterday, then today my husband said since our Super Med Classic was being discontinued, he switched us to Super Med Plus and it IS still covered. I called them and they verified that! I, too, am having problems with them in regards to the 5 yr weight loss redtape...but I just sent them photos via certified mail with a return receipt, and my own personal weight loss record in a 3 page letter. I included copies of my WW books and also a letter from WW corporate headquarters that said I was in the program in 2000. (I lost the book for that one.) Also sleep study results (I have severe sleep apnea), a letter from my dr with weights for 3 of the 5 years, my psych evaluation. I also copied the letter to the Ohio Dept of Insurance and my attorney. (I figure it can't hurt, and they can see the CC: at the bottom of the letter and know I mean business. I wish I could find the receipt for my treadmill! Or Metabolife! Don't give up!! I'm not! Pamela