After battling PEBTF

and getting nowhere.  I wrote to ACLU due to PEBTF's exclusion of medical procedures for obese individuals in the same situation I am in.  I got shot down by ACLU, stating they can't help me.  They gave me a list of agencies and government offices to contact.  I contacted those agenciea and government offices, they in turn to me to plead with PEBTF, which ended up in me contacting ACLU.

I know someone who got the green light....  thing is, she's NOT following  the program.  SHE STILL eats like a slob.  She purposely put on weight (350 lbs up to 450 lbs in just a few months)  to get medical problems to get the surgery and welfare IS paying for it.  She brags about it to me and it's putting a big wedge in my marriage, because she is my step daughter.

Unless I win the lottery, I am STUCK being obese and miserable.  Anti depression pills are NOT helping me on this.   Either this or do however many different over the counter weight loss gadgets until I can get the weight off. IF that doesn't work, then I quit trying..

Geisinger had a HUGE XX million PROFIT.. you'd think they would help someone in my position. 

Sorry to hear you are going through all of this. I know it is a long shot but what about writing to talk shows or news agencies? Oprah, Ellen, Rachel Ray - maybe you'll get lucky!!

i just wrote to oprah, ellen, wnep, wbre and wyou. 

yeah a long shot..............with Murphy living in my house, i doubt it will help. 

Murphy's law... anything that can go wrong will...  or something like that. 

compressor on our fridge is on the blink and the freezer is not freezing right.  means we have to get a new fridge.  thank god for rent to own!!!  new fridge coming friday.  70 a month for 18 months... 

and we need new tires for inspection

I would be just as upset as you!  I can't stand the ridiculousness (is that a word?) of healthcare in general in this country, let alone the whole WLS thing.

Hugs because I have no real advice for you.

Pam

Your step daughter sounds like an awful, petty, disgusting human being.

I self-paid, and it makes me sick reading about someone BRAGGING about having welfare pay for their surgery.

I would pay her no heed (which I'm sure is easier said than done).

Have you invesitgated out-of-country surgery? I never did, but I've been told it can be significantly less expensive.

It is easier said than done when dealing with the stepdaughter.  we are raising her 2nd kid.  been raising her since she was 2 days old.  she'll be 6 in november.  she got pregnant with her in hopes that they would not send her to prison because of being pregnant.  she ended up there anyway and gave birth to her daughter in prison. 

as for out of country surgery, have to be able to get there and afford to pay for that. 

i once joked to my husband that i could force having it by stabbing myself in the stomach, but that would end up with me in the psycho ward.  and i don't like blood and pain.

I have debated for awhile about whether to even entertain a reply to this post....... That being said, my dignity and integrity both tell me that I deserve to have my 2 cents in this (being that I'M that awful, petty, disgusting human being which you speak of)! I have confronted Jacqueline about it in a more direct way, but I feel I need to add a little clarity to the things that have been said.

First of all, no one and I mean NO ONE knows the true cir****tances surrounding ANY of my problems. At some points, even I don't know why I have the problems I have, especially when there ARE people out there who weigh 400-450 lbs and don't have the problems I had. Please don't pass judgement on ANYONE for how they pay for their surgery or why they get it. I am well aware that this post was written and replied to nearly 3 years ago. However, time does not take away the sting from reading this. As a matter of fact, we shouldn't judge ANYONE at all for any reason unless we know the whole story for ourselves.  The same person who put me down for how I had my surgery paid for is (crossing fingers) having her surgery paid for in the same manner: Medicare/Medicaid. Granted, she has to fight a little harder for hers, but in the end it's still the same. (At the time this was written, this was not the case for her. She was struggling like crazy and I felt bad for her!)

Did I go from 350 to 450 in a matter of MONTHS? Hell no! As a matter of fact, when this post was written, I hadn't even crested to the 420 mark. I started gaining the extra weight after my 3rd and final child was born in 2005 and I wa**** with a DEEP depression. I've weighed over 300 lbs since 8th grade, so even then I would have been able to get such a surgery because of my high BMI. The weight came on gradually, just like most of us. I gained the first 80 lbs of extra weight over 2 years and then the last 10 (as far as the date of this post goes) over a year or 2.

I entered into the program at Geisinger in Jan of 2009. I followed the program and within the time given, hit my goal loss for the program. What stopped me in the program? MONEY! I couldn't  pay their global program fee of $375. So, even though my surgery would have been paid for by gateway/MA, there was still an out of pocket cost that I couldn't pay...... I stayed in their program, however and continued my weigh-ins...... My weight fluctuated like crazy. Not because of my diet, but because of the unmanaged LYMPHEDEMA I had in my right leg (I have since learned how to manage it).

How can anyone judge someone's eating habits if they don't  live with them or aren't around them 24/7? At this period of time, we lived an hour away from each other. The only time we were around each other for meals was for SPECIAL OCCASIONS. Yes, I overate on those occasions. Do I admit it? YES. Does that mean that I ate like that ALL THE TIME? NO. However, I will admit that because of my frustration and discouragement within my journey during that period of time, I definitely did eat more than I should have. I thought I was never going to get through any of it.

Did I brag about how my surgery was being covered? That is a matter of opinion. No, I didn't run around saying, "Nyah Nyah Nyah Nyah Nyah Nyah!" Matter of fact, because my dad asked me, I didn't talk about it...... Was I asked how it was covered? Yes. Did I answer? Yes. Was I ****y about it? Not that I know of.....

Fast forward to about Sept of 2010. Geisinger drops Gateway as an accepted insurance. Didn't know that they still would have accepted it for the program, but it's a moot point now. Oct 2010, moved...... Whole program is a moot point because I moved out of the area.

Since then, I have gotten medicare and medicaid as insurance due to being disabled because of having stenosis/degenerative disk disease in my neck. I entered into a program in York with Dr. Monk and jumped through more hoops and finally had my surgery on Dec 29th, 2011. Regardless of how I ate prior to surgery, we all know that it is physically impossible for me to eat like that anymore. I've lost 83 lbs (as of yesterday) since signing my papers for surgery (that's the weight that they go from when they total  your loss). I weighed 414 on the day I signed my papers. I now weigh 331. If I'm not working a program, how have I been THAT successful? I don't care.... I'm PROUD of MYSELF!

Finally, there is one more point I need to clarify. This upsets me more than anything that was said about my weight loss journey........ I did NOT become pregnant to AVOID going to jail! I found out I was pregnant 2 weeks after going to jail. I didn't even KNOW I was pregnant or SUSPECT being pregnant when I went to jail! Hell, I didn't even know I was going to end up in jail at all! Did I hope that I wouldn't do a lot of time because of being pregnant? HELL YEAH!!!!! I had a one year old son at home with my mom who I missed dearly and the thought of having a child while in jail was horrifying! I would NEVER wish having a child while in jail on ANYONE! Not even my worst enemy! The day I had to walk away from my 2 day old daughter to return to prison was arguably the WORST DAY OF MY LIFE!  To this day, 8 1/2 years later, I still do not have my daughter with me. I have my son back, have since had another daughter who I have been with since the day she was born, but I still don't have my daughter with me. I've improved my life in leaps and bounds, become a better person, gained stability in my life, yet I STILL do not have my daughter with me.

All this being said, I'm simply asking all of you..... DO NOT pass judgement on someone until you know them or have walked in their shoes. You just don't realize who you're hurting!
 

That took a lot of moxie to write and I applaud you! Lots of folks get MA now that PA is a Medicaid expansion state. Nothing to be ashamed of - we all need help sometimes. I work for welfare and I tell people that everyday and I believe it. Keep up the great work. It sounds like you're really back on track.

Sharon

 I feel your pain. I was in the same boat for 6 years. I even tried suing an insurance company. They were horrible, rude, patronizing insisting that WLS was too dangerous. In the time it took me to finally have the surgery (under a different insurance) I developed diabetes and I am still angry about this. I wish I had some words of wisdom for you but very few people in the Health Insurance industry let alone our government GET IT! I'll keep you in my thought and prayers because I know your pain. What is PEBTF?

PEBTF is Pennsylvania Employees Benefit Trust Fund.  We have GHP through PEBTF because my husband worked for the state.  We cannot to pay for insurance premiums, so we are stuck with the insurance we have.