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Will I Be Approved??

madisonPA

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This is my first blog...on any wesbite...so please bare with me.lol

 

I went to a seminar on Monday 3/5/12 and now I want this surgery more than ever.Ive been overweight my entire life and have tried many things.Im ready to work on my body image more than every because I finally finished school and I've landed a good job with great benefits.Now that I have that stress out of my life Im ready to tackle this weight.I know this will be a longggggg process to get everything together but Im ready to make this change. However, I feel like I have a few roadblocks preventing my from laying on that surgery table in a few months.

 

1.My bmi

-My bmi fluctuates between 39-41 every few weeks.I dont have high bp or diabetes. I used to have asthma when I was younger but I haven't had an inhaler in years. My bf thinks I have sleep apnea because of my sleep pattern. I'm afraid if they do do a sleep test and it proves that I don't have it it will lessen my chance of being approved.I don't want to be forced to gain more weight just so I can stay over that 40bmi mark to have no comorbidites as a necessity to be approved.

 

2.History of weightloss

-Ive been a member of the gym for the past 2 years and its easy to verify that(automatic checking deductions). But how can I prove that I been trying other things bc its been so long ago. I cant find reciepts of when I brought slimquick and all those other diets a year and so ago. Do I show him pictures? Do I bring in empty bottles of stuff that Ive taken in the last 6 mos?? How do I know that I have enough proof??

 

3.Primary Care physcian

-Ive had abt 4 different pcps over the last few years bc it was only recently that I finished school and was able to start working fulltime again and have benefits. I have a brand new pcp that I just made an appt with. Will the barriatric dr not approve me bc I havent been consistant with a pcp bc of my lapse in insurance?

 

I get so upset thinking about all the what-ifs that comes along with this process. My 1st consult isnt until the 29th which seems forever away so Im left with all these thoughts about being rejected. Its so hard to stay positive because I really feel like this is my last chance and if I get denied I dont know what to do. *sighs* :(



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Main thing to do is check out your insurance coverage. What do they require. Some require that you have a period of time you was under a dr care trying to lose weight. I had to list 2 years of things i tried for my dr he did not require proof just a list of what i tried and for how long and if any was successfull. My insurance though required that I do 6 mos of what is called CareWIse. Where I had to talk to a nurse and a dietican on the phone every few weeks for 6 mos. I am on my last month of that. Good Luck!

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Thanks for your reply.Congrats on your last month.:)

Hopefully this dr will require only a list too.Im most worried about that factor. I talked to my insurance company(bcbs) the day after the seminar.My insuance does not require the 6mos weight loss period.They only require a bmi over 35 with co morbidities or 40 with proof of weight loss tried.

I wish my appt was sooner so I wouldnt be wrecking my brain about this.

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MadisonPA, you are at 40 BMI now then your insurance will probably approve you. I know my insurance required records to show where I had attempted weight loss and failed because of regaining plus some and a 3 month follow up with PT, Dietary, Psych and my surgeon but was approved. I promise you my documentation wasn't the best because alot of stuff I tried on my own, but I did inform my PCP about it and it was approved the first go round, I have had my surgery and am loving it. Try not to stress, it will work out in the end.

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Do you have a gynocologist you go to for yearly check-ups? My gyno had more documentation about my weightloss attempts then my GP. She wrote a letter that said I was her patient for over 10 years and in those 10 years I had failed time and time again at losing weight and keeping it off. If not, I'm not sure. My insurance required that kind of info even with BMI at a 45. Don't panic though. The bariatric doctor wants your business and if they are like mine will do all of the leg work to get you approved. You don't need to convice them, it's your insurance company. Good luck!

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Thanks Karla.This puts me a bit more at ease...... Congrats on your surgery :)

Thanks Otter.What a great idea to go to my gyno....You are so right@business/making money.I think im starting to feel more positive. :)

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My doctors office sent me a TON of questions to answer and some where really uncomfortable to answer but they had to be. Pretty much my insurance wouldn't cover anything but the doctor said i was perfect to have the surgery i have pos and i had high blood pressure. Pules i had other things but you will never know until you try it. They also have payment plans well they do at the dr that i went to. Good luck and i hope everything works out for you. And thanks to records form my gyno that helped too.

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Also, if you've ever tried anything like WW, I've heard of some people going to the center where they attended meetings and being able to have the center print out copies of their weigh in records for insurance approval. You might try that!

Still, with a bmi near 40 and sleep apea, you shouldn't have a problem. I'll cross my fingers for you. :)

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I also have BCBS, and was not required the 6 month weight loss. I did not have to show proof of past weight loss attempts but I did have to prove 3 years weight. I go to my gyno regularly so he was able to give me the 3 years weight needed. It didn't matter for me if my weight went up and down, it just mattered that my weight was over 40 bmi all 3 years. I have sleep apnea too but a comorbidity was not needed since my bmi was over the limit.

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