Tina Martin

Hi everybody. My name is Christina. I am from North Texas. I am 23, happily married for four years and a full-time student about to graduate. I have a seemingly good life, except for the big elephant in the room...which is me. I currently weigh 356 pounds. I have a BMI of I believe 58.1. I decided about 5 months ago to go to a Lap-Band seminar, and met up with "True Results". I have been doing all of my lap-band insurance approval requirements through them. I have Aetna: Open Access. I went through the four-months documented nutrition meetings, chest x-ray, blood work, psychiatric evaluation, sleep apnea test and submitted all the documented "weight history over the past two years" that I could. Here is my problem. I was denied. I was denied because I could not prove that I have been morbidly obese for two years. I did not have insurance until about 6 months ago. I did not have insurance between 2008-2010. I found two more records today from 05', and one from 07' from an emergency room. I do not know what to do. I was wondering if anyone had any suggestions? Can I submit pictures with time stamps? I have plenty of those. I would really appreciate all of the advice/help. You are all such wonderful, strong people. I have been reading your boards for months and never had the courage to join and say anything myself. Has anyone else gone through this? What should I do? Thank you, Christina.

I am scheduled for the lap-band surgery on Tuesday (the 12th of July, 2011). I was put on a 5 day liquid diet. I am not doing so well and am at the point of calling my surgeon and canceling the whole thing. I have had 6 Protein shakes, trying to stay full and not have headaches. I have "cheated" three times now. Has anyone had problems with the pre-op liquid diet? I'm sure it wasn't easy for anyone, but this is just killing me. I am to the point of just giving up. Depressed in Bedford, Christina.

I'll make it a quick summary. I have Aetna Open Access. I went through True Results to do everything required for my insurance approval; the four months of nutrition consults, psychological evaluation, 2 year weight-history documentation, chest x-ray, etc. I was denied because I lacked proof of being obese for two years. I appealed with pictures and was approved. In the letter, it says that I was approved for "Gastric-Bypass surgery". I had appealed for the Lap-Band surgery. Any idea what this means? I would not mind having the gastric-bypass surgery, but I had originally planned to have the lap-band. How can I get approved for Gastric-Bypass when I did not apply for it?

Erin, I really do not think that you have anything to worry about. The same thing happened to me. I asked my patient advocate and she said that it will NOT affect your insurance approval because you are not REQUIRED to lose weight to get approved. Now this was the case with Aetna. I am not sure what insurance you have, but it may be different. You may want to call and ask.

I did find some records from 2007, and two from 2005. I did also find some pictures. One with a time stamp and one without. I am hoping that this goes through!

I do not have diabetes. My doctor told me I am "pre-diabetic", but I do have high blood pressure.