shawna_s

June 19th is my surgery date as well!!

Very positive and a great reminder!

I have had 2 c-sections and recovered pretty quickly overall. Are they similar? My friend who has lap band but no c-sections seemed to think it was different b/c of the locations of the incisions, etc. Did you need help getting out of the chair for a few days?

Well I love my friend to death, but when she said she had to have her husband help her out of her chair for almost 2 days I was a little dumbfounded!

You will get there! It is so hard after babies!

I also have 2 boys one with autism. I feel like my depression from the dx is kinda what got me in this mess (or lack of will power.. ha ha), but now I need to fix it! I gotta be here for these kiddos!!!

For my insurance to cover i have to have a 40+ BMI. RIght now I am sitting at 39.4. The surgeon's office wants me to do a sleep study. I would be VERY surprised if I actually have sleep apnea, but am doing the test anyway. Anyone else do the test for insurance reasons and turns out you actually DID have it?! I am trying not to get discouraged, but it seems like a waste of time.

Well, that is what I wanted to hear! I don't care if it is true or not, as long as it will help my case with insurance! ha ha!

I just got off the phone with the surgeon's office and she pulled up the policy. She said they don't require it at all and don't require the nutritional eval either, just psych! I am going back in for my reconsult 03/21!!!!!

ahhh! I hope you ladies are right! I have a call in to the surgeons office!

great job! I bet that feels amazing!

Has anyone been denied because they gained weight during the 6 month supervised diet??? I legitimately gained 5-7 pounds b/c of medicine I was on, but I was still 8-9# shy of meeting the 40 bmi requirement, so I cheated a bit. Well, I cheated more than I thought and the doc's scale said i gained 15# in 1 month...AHHH! I am afraid it will be obvious as to what I did and they will deny because of this. Anyone know??

I know they want 6 consecutive months. So if I were to start over in a month or two I would have to start my 6 months ALL OVER AGAIN! Is that what you are asking???

Does anyone know if being apart of WW for 6 months counts as part of your 6 month dietary plan and exercise?

Has anyone been denied because they gained weight during the 6 month supervised diet??? I legitimately gained 5-7 pounds b/c of medicine I was on, but I was still 8-9# shy of meeting the 40 bmi requirement, so I cheated a bit. Well, I cheated more than I thought and the doc's scale said i gained 15# in 1 month...AHHH! I am afraid it will be obvious as to what I did and they will deny because of this. Anyone know??

I wouldn't say I have had bad luck with them, but they told me in the spring that i had to have 3 months of dietary supervision and then once I did that they denied me and said I needed 6 months. I am now on month 5. Let me know what you find out!!! Good luck!

I think this is the surgeons guidelines, but not the insurance guidelines.

I am also curious if anyone has followed up about this. I was told 3 months, hit 3 months and was then told 6 months, if they change it again I am going to lose my mind!!!

Hi there! I am so frustrated right now! My insurance company told me that I need to have a 3 month "weigh-in" period with my primary with diet/exercise plan in place, etc., get the psych eval, and nutritionist. I did all of those things and they just denied me! My BMI was 37 at my first visit and unfortunately due to some hormonal problems I am having I have gained probably close to 10 pounds and I think my BMI is 38 now. The only comorbidity i have is asthma. No high BP or anything else. I haven't had labs drawn in awhile, so I am not sure what my cholesterol is, but I am wondering if i need to go eat a cheeseburger before i have labs drawn instead of fasting to get approved for the surgery... ha ha! Anyway, my main question is this: Has anyone else been denied by BCBS of IL? If so, how long did it take to get things straightened out with them? I am so bummed right now!! I really don't want to wait another few months!!!!

I could be wrong, but if you don't have the coverage, I don't think you have any options. My only suggestion is to maybe check into getting an individual plan through someone else. I am checking into this as well, but I heard that individual plans don't cover it either, only group ones. I don't know if that is true at all, but that is what I read. Hopefully you can find something out soon! Good luck!

seriously!? so they won't cover a procedure you need done to prove you have sleep apnea, which is of course "shoe in" for the lap-band. What jerks!

Thanks for responding! If you don't mind me asking, was your BMI over 40? I think that is going to be the deal breaker for me b/c I don't have any other comorbidity besides asthma.

It just kills me that they wouldn't say from square one that " you don't qualify" instead of them paying for me to have the nutritional eval and psych eval and all of the freaking doctor visits. It is a waste of money for them to make it sound like it will happen and then deny, then to just deny it from the beginning.

Maybe i will try the congressman thing. Not sure it will work for me, but maybe it will. The only thing that I know (or from what I can tell online) is that BCBS of IL changed their policy from 3 months to 6 months of supervised diet sometime in March or April, but they told my surgeon's office 3 months around June. Maybe I can get them for quoting me wrong info? I know it is a long shot, but man I am just so disappointed and tired of being fat!!!! I can't believe you had already started your diet and they said no! How frustrating for you! Glad they got it appealed for you!!! **Oh and i have asthma and joint pain, but those are the only comorbidities. It is weird, because when I calculate my BMI online, it says it is 38 now, but when the nutritionist wrote my BMI down in her letter, it was 41.1?