Feeling this ordeal may be futile
I am a brand new reader here, and have only just begun seriously considering WLS. My apologies if this is posted in the wrong place; I didn't see anything for newbies.
I've struggled all my life with weight, and have been in the morbidly obese category for the last 9 years. I have lost weight countless times, but each loss was short-lived and even more weight came back on. I've spoken to several people who had WLS in the last year, and most recently one of my dear friends who lives in another state. This friend has inspired me to reconsider the surgery, because I truly believe I will never be able to maintain a healthy weight any other way.
I've never entertained the idea of WLS because of insurance reasons - believing they won't pay for it. But after browsing the Baptist Hospital website, and making a call, they urged me to come in and fill out paperwork. I'm afraid that will be a waste of time and will be another disappointment. I've got Cigna insurance (Metro employee, not State of TN), and their documentation says documented weight-loss efforts for 2+ years or something along those lines. I have a co-morbidity of sleep apnea and asthma, but I am assuming this means I'll have to put this off for 2 years while I 'attempt' to lose weight that comes right back.
Have others been through something like this successfully? I need some kind of success story. I have all but resigned myself to a lifetime of being fat, and the idea of getting my hopes up again seems almost too much to bear. Thanks to all who've read.
I've struggled all my life with weight, and have been in the morbidly obese category for the last 9 years. I have lost weight countless times, but each loss was short-lived and even more weight came back on. I've spoken to several people who had WLS in the last year, and most recently one of my dear friends who lives in another state. This friend has inspired me to reconsider the surgery, because I truly believe I will never be able to maintain a healthy weight any other way.
I've never entertained the idea of WLS because of insurance reasons - believing they won't pay for it. But after browsing the Baptist Hospital website, and making a call, they urged me to come in and fill out paperwork. I'm afraid that will be a waste of time and will be another disappointment. I've got Cigna insurance (Metro employee, not State of TN), and their documentation says documented weight-loss efforts for 2+ years or something along those lines. I have a co-morbidity of sleep apnea and asthma, but I am assuming this means I'll have to put this off for 2 years while I 'attempt' to lose weight that comes right back.
Have others been through something like this successfully? I need some kind of success story. I have all but resigned myself to a lifetime of being fat, and the idea of getting my hopes up again seems almost too much to bear. Thanks to all who've read.
Denise M.
on 3/24/09 5:29 am
on 3/24/09 5:29 am
Welcome to the club! Most of us have been in the same place as you--lost weight, gained it back, lost it again, gained even more. Got frustrated and decided to explore other options.
I would definitely move forward with researching programs and hospitals that take your insurance. Talk to your HR/insurance people at work to see what other stipulations their policy may have for WLS. Do you know of anyone else in Metro that has had it done? If you can find them, talk to them.
It might take a few tries to get it approved, but I'm betting you can. It's a process and it definitely takes time. But it is definitely worth pursuing. There's a board here at OH that focuses just on helping people appeal denial and getting it approved.
Attitude is half the battle. It sounds like you're pretty down, resigned to a life of being fat and not wanting to get your hopes up. But nothing ventured, nothing gained. If you want this badly enough, find some strength inside to keep making those calls, go to seminars and doctor's appointments and see where it takes you. Even if you have to go on a long term weight loss effort before submitting to insurance, it's better to get started on this journey now than to wait . . . and regret.
It has taken me nearly a year from the first seminar I attended to my upcoming surgery date. I suspect all the hard work will be worth it in the end. And I haven't even gotten to the tough stuff (surgery) yet.
Good luck on your journey. Read the boards and educate yourself. There's lots to learn here. And ask away with the questions. We're all here to help each other.
All the best,
Denise
I would definitely move forward with researching programs and hospitals that take your insurance. Talk to your HR/insurance people at work to see what other stipulations their policy may have for WLS. Do you know of anyone else in Metro that has had it done? If you can find them, talk to them.
It might take a few tries to get it approved, but I'm betting you can. It's a process and it definitely takes time. But it is definitely worth pursuing. There's a board here at OH that focuses just on helping people appeal denial and getting it approved.
Attitude is half the battle. It sounds like you're pretty down, resigned to a life of being fat and not wanting to get your hopes up. But nothing ventured, nothing gained. If you want this badly enough, find some strength inside to keep making those calls, go to seminars and doctor's appointments and see where it takes you. Even if you have to go on a long term weight loss effort before submitting to insurance, it's better to get started on this journey now than to wait . . . and regret.
It has taken me nearly a year from the first seminar I attended to my upcoming surgery date. I suspect all the hard work will be worth it in the end. And I haven't even gotten to the tough stuff (surgery) yet.
Good luck on your journey. Read the boards and educate yourself. There's lots to learn here. And ask away with the questions. We're all here to help each other.
All the best,
Denise
Welcome to the TN board! First of all, don't give up so easily! I waited WAY too long too have this surgery. I was 50! I should have had it 10 years ago or more! You are just beginning this battle and believe me, it is nothing, if not a battle, and it does not end at the surgery. So decide if this is worth the trouble for you then put on your armour, pick up your sword and get ready to fight for yourself. We will support you along the way!
I really can't help you much as far as the 2 + year weight loss thing. I know there are some people on the board that can. You also might try posting this on the main board if you don't get a lot of response here. Have you done Weigh****chers, WeighDown Workshop, Jenny Craig, NutriSystem, anything that was a quaisi supervised diet in the last 2 years? Some insurance companies will accept that. Don't be scared to call them and ask them what exactly they require. They have to tell you. Ask for a specific list, Then start working on it. Many people have to do a 6 month diet, or have to prove 5 years of morbid obesity or have to lose 10% of their body weight. Most have to have a psych eval. I wasn't so lucky. Both my insurance and my husband's had an ironclad exclusion written so I had to self pay by taking out a loan and using my 401k. That's what I mean by being sure you want this surgery. I felt like I would die without it. I wish you good luck. Now, look deep inside and find the strength to fight for what you need!
I really can't help you much as far as the 2 + year weight loss thing. I know there are some people on the board that can. You also might try posting this on the main board if you don't get a lot of response here. Have you done Weigh****chers, WeighDown Workshop, Jenny Craig, NutriSystem, anything that was a quaisi supervised diet in the last 2 years? Some insurance companies will accept that. Don't be scared to call them and ask them what exactly they require. They have to tell you. Ask for a specific list, Then start working on it. Many people have to do a 6 month diet, or have to prove 5 years of morbid obesity or have to lose 10% of their body weight. Most have to have a psych eval. I wasn't so lucky. Both my insurance and my husband's had an ironclad exclusion written so I had to self pay by taking out a loan and using my 401k. That's what I mean by being sure you want this surgery. I felt like I would die without it. I wish you good luck. Now, look deep inside and find the strength to fight for what you need!
Marilyn
Smoky Mountain Obesity and WLS Support Group
1/17 6:30 LeConte Medical Center
I have CIGNA insurance as well, and what they wanted from me, was something from my doctor stating the methods I've tried in loosing weight, ie, Weigh****chers, Sugar Buster Diet, Atkins, etc... I then had to have 6 month of supervised weight loss, which my PCP did. That combined with a psych eval, a sleep study, 5 years of weight history which I got from my gyno, and my PCP recommendation with all my other troubles... (I have sleep apena, polycycstic ovarian syndrome, thyroid problems, and high blood pressure.) Never hurts to throw in some joint pain too!
It took some work, I started the process on Feb 5, 2008, I was approved on Oct 30, 2008, and had surgery December 9, 2008.
Don't give up, I have no regrets making all the phone calls, getting all the paperwork together, my ONLY regret is not doing it sooner!!!!!
Hope it helps, and good luck!!!
Please don't give up.. it can all happen for you if you make it happen!
It took some work, I started the process on Feb 5, 2008, I was approved on Oct 30, 2008, and had surgery December 9, 2008.
Don't give up, I have no regrets making all the phone calls, getting all the paperwork together, my ONLY regret is not doing it sooner!!!!!
Hope it helps, and good luck!!!
Please don't give up.. it can all happen for you if you make it happen!
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