Question:
can someone please help im feeling discouraged..
i have health insurance and it was checked..i have benefits for the surgery..i found a dr that i like and went for my 3hr appointment but am now feeling discouraged and hopless..i am 5'5 and have a bmi of 39..the dr told me that my insurance will deny me if he puts it through..i have semi high blood pressure now but havent been treated for it..and he says i need proof that my weight was the same or higher 5 yrs back..which i had no insurance at the time so have no proof of that..i was so happy about being healthy and starting my new life and now i feel sad and hopeless..any suggestions or where i can turn to in order to fix this? — carissamarieg (posted on April 5, 2009)
April 4, 2009
Carissa,
You didn't need to have insurance in order to prove your weight for the
last 5 years.....as long as you have doctor records over that period of
time that is sufficient....
Good Luck!!! Donna
— gonnabethinfinally
April 4, 2009
yes i guess what i meant to say is i had no insurance therefore had no
doctor so have no proof of my weight
— carissamarieg
April 4, 2009
Hi Carissa,
Did you visit ANY Dr. during the five yrs? Did you have a DR. before that?
There are ways to get around that. Call your ins. yourself ask them what
the time line is to be under Dr.s care for weight lose before surg. or just
ask them for what correct process is the have your surg. In my case...I had
to have a yr. of documented weight loss with my primary care DR. we went
back into my chart and used my DR. visits to document it. The Bariatric
surg. gave me the pre-reqs for surg and I had all of the test...sleep
apnea, EKG, physic eval, I know there were others but have forgotten them.
DONT let ONE NO discourage you!! Maybe youjust have to look harder and get
your ins. to give you all the info and find a DR in/on your side. But I
would start with my own ins. company and actually get what they REQUIRE for
you to have surg. Best of luck.
— tootsie52
April 4, 2009
Did you go to Weight Watchers, Curves, gone to the ER in the last five
years? This is a long and hard road with lots of hills and valleys. I have
felt the same way you are feeling a time or two. Last weekend in fact. I
have a little pity party for myself and then get back on the horse and keep
going. I have jump through to many hoops to give up now. Where there is a
will there is a way. Chin up. You can do this. Have a great day.
— dsquire
April 5, 2009
Did your surgeon say you needed 5 years or does your policy state this?
For example, mine said I needed 6 months of dieting by my physician. I
did not have any of the top three co-mobities, ie: high blood pressure,
high cholesterol, or diabetics and my bmi was 35. I did have gerd, joint
pain and multiple other issues that are associated with obesity. I also
had every doc that I knew write a letter to the insurance co in regards to
my need for a lapband. I even wrote a heart felt letter from myself. I
filed on Jan 2, an was approved Jan 5. I am sure you doc's office staff
knows best..I have BC BS...every policy is different. Keep reading and
then read some more. Goodluck Kimberly
— kfgates
April 5, 2009
easy, relax, you remember the old saying " a picture is worth a
thousand words?" Put together lots of pictures of yourself, from the
time you became obese, date them and submit. Seeing is believing. Good
luck and remember there is more than one way to skin a cat. Cindi M.D.
retired -230 5 yr post op r n y
— DollyDoodles
April 6, 2009
Whenever I went to the doctor I refused to get on the scales so I had no
record either. I did find one record of my weight when I went for a bone
density test.They made a copy for me and then my insurance co. made me go
on a 6 month, doctor supervised diet. It took a while but they finally OK'd
me. Don't get discouraged. The insurance companies are just testing you.
— Muggs
April 6, 2009
My doctor was very negative about getting the approval as well. It turns
out my insurance always sends a denial with instructions of what to do to
get the approval. The process then took 6 months of weigh ins and diet and
exercize records. Have him submit the request and see what they say. You
can always appeal the decisions.
— trible
April 8, 2009
I had the same problem, having not gone to the doctor for the past 5 years.
Also, when I contacted my insurance BCBS of IL they told me that they were
really strict on the requirements. However, my surgeon sent in everything
but the weight history and I was approved within one week. You might also
get tested for sleep apnea, that way you have two reasons besides just the
weight and hopefully your insurance will approve your surgery. Good Luck!!
— jen5023
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