six more months..........at least!

Oh folks, I am so disappointed, frustrated, angry, bummed, and whatever other adjective there is out there!!  I got a letter from the ins. company.  They denied my surgery........need to be on a doctor supervised food plan.  Does anyone know does it have to be six months?  I looked on the website and the guidelines are "just" to have been on a dr supervised diet within the last 2 years!  I called and the gal .... Stephanie, was very nice and sweet, but she did not have any info as far as how long I had to be on this diet.  I know I can lose weight..........just can't keep it off.  AND I don't want to become diabetic during this time which is my really big fear.  Ugh.......so disappointing!

Well, thanks for listening.  It is difficult for me to share on here, since I don't feel I have thata mu*****ommon with you at this point yet.  I am still here and I do still read at least twice a day!!!

Hugs..........Vickie

Hi, Vickie:

Different insurance companies ask for different times of supervised food plan.   I don't know as I have heard of one lasting 6 months!  

Have you talked to your Dr. yet?  They may have you go to a Nutritionist but they will know how long you have to be on the plan.

don't give up!

Blessings,

Jeane

Yes, went to Dr after work........I have a sinus infection, have been sick since before Christmas.  I have had so much going on in my little world and I think my stress level is so high, and my immune system is very low!!  Finally decided to go to DR today, then got denial in mail....was really bummed about it!  Dr will work with me.  She was going to have me go to a nutrionist, but that would me time off work as the closest nut. is about twenty minutes away, and I don't want to take time off if I don't have to.  So.....agreed to start Weigh****chers for the umpteenth time!  And she will keep my journals and do a weigh in at her office monthly!  Dr not sure how long it has to be........think I will call again Monday to ins company and see what the person on the other end says (this time!!!)

Hugs........V

Hello,
A lot of insurance companies ask for a six month diet plan.Mine did. I have one more appointment
and then I can get the okay, hopefully, for the surgery. It is really hard to wait but the saying , all good things come to those who wait, has been a comfort to me. It means the best is worth waiting for. I have learned a lot about myself in these six months and I am going into this with most questions answered. I feel confident I will succeed where as six months ago I wasn't sure. The time will go by and before you know it your time will be here. Nancy

It can be very frustrating, but hang in there because it will all be worth it.  I started my process in Sept 07 and just had surgery 3-1/2 weeks ago.  Once I did my 6 month diet and went for my required tests (nuclear stress test, chest xray, etc.), thinking I'd be having surgery this summer, they found a couple of spots on my lung and I had to go through a bunch MORE tests, plus a waiting period to see if the spots would go away.  Then a biopsy.  Finally the doc cleared me for surgery in October and I was finally scheduled for December.

I did get discouraged because my entire summer was taken up by doctor visits and it was stressful wondering what was up with my lung, etc.  But now that the surgery is done and I'm on the other side, it all seems long ago and far away.  Now I have something positive to look foward to - the losing part of my journey!!

Good luck, Vickie!!

Hi Vickie,

I had gotten all my tests done in 2 months before I got to see my surgeon for the first visit, where he told me my insurance req'd a 3 month supervised nutrition and exercise plan.  I had already been going to the gym consistantly for the previous 2 yrs, but did not have a trainer or exercise phys who could verify that, so I got a trainer, and began seeing the nut for those 3 months.  I had to delay my surgery as well because of that. Let me say, it was worth it.  I learned so much those 3 months, and I feel I was way more ready for life post surgery than I would have been if I had not had that experience, as frustrating as it was when I was standing where you are standing today.

My suggestion to you would be to call your ins co, but when you get the person on the phone who doesn't know anything and can't give you an answer as to what EXACTLY and SPECIFICALLY they are requiring of you, ask to speak to someone else above that person, and if you can be directed to the department where they do the approvals, even better. 

Don't give up on trying to find out what is required, and don't give up on trying to follow the plan one more time.  You will lose weight, and have a head start for when you finally do have your surgery.  It will all work out in a way that will prepare you for the new life you will lead post-surgery.

Best of luck!

Cara

You don't have that mu*****ommon with us?  Oh, hon, don't do that to yourself.  We've all had hopes and dreams about our surgery that were dashed.  My "No' from three years ago turned into a Not yet" and I had my surgery in Oct.  Note that at the time I was bummed, angry, etc. just like you.  Just get it all out and resume the fight tomorrow.

Hi Vickie

Which surgeons office are you using? I forgot...I had to do a 6 month diet too. I just went in to the office every month, got weighed and we talked about how hard it is for me to lose any when I can't be very active. They kept very good notes though. The surgeons office said it had to be within the last 3 years. Have you dont weigh****chers in that time? If so, that would count too.

I tried to get my previous diet to work, but it had been too long ago. So i just went in every month. Then they filed my papers on Tuesday and by Saturday I had the approval! I have medicaid, I didn't think the government could move that fast!

Just hang in there, you'll be fine. I've always shared on here, even not having surgery yet, you pick up lots of good ideas, and I'm sure you can share some too. After my surgery I'm sure I'll be here whining and stuff...lol

Take care,
Nancy

Vickie,

HUGS!! The common thread is that we ALL have a weight problem Sweety.

Call your insurance company and ask for their guidelines IN WRITTING. Look it over then make a check list of what you need to be approved, then take it one step at a time.

During that time, read, learn, ask tons of questions so you are better prepared for the new life after WLS. Think of this time as your WLS Internship and you are cramming for the finals.

When I started, my surgeon wouldn't consider me because of my weight, age and co-morbidities. He sent me to the dietitian with no specififcs other than, "lose weight and we'll see how you are doing".

I was determined to do whatever he asked. It took several months before we even talked about testing, submitting papers to the insurance comapny, or anything but proving my determination.

Frustrated, disappointed, bummed ..oh yeah - I felt it too.

Hang in there - it is well worth the time and effort.

Kisses
Annette

Hey Vickie , dont have that mu*****ommon? most  all have had to fight in one way or the other to get this surgery done. there are a few lucky ones that just decided and wham bam thank you mam got it done but most do have 6 month weight and exercise too restrictions. they dont say you have to lose weight just that you have to be in a supervised weight loss program....they want to know that you can follow a program so you can lose small amounts of weight and they are happy...lot of insurance companies also require that you be in a supervised exercise program too. so you arent so different. be sure and call your ins. company again and if the sweet little receptionist who answers phone calls knows nothing ask to speak to someone else. keep records of date called and who you talked to and about what. just in case. ok sometimes you have to really get pro active to get them off their butts....once you find out what the restrictions are there if any. sometimes there is no restrictions at all when you actually find someone that knows what the policy really says. do you have a copy of your policy? sit down and read it thru and thru...