college_chick

I have to write a letter that explains that I was on phentermine at the time. So hopefully that works.

I got the news yesterday that I was denied. On 3 of my weights from 2011 I clocked in with a BMI of 38.94, 38.1, and 39.1 with no comorbidities. Every other date I met the 40 and above requirement. I'm hoping to appeal this somehow and I'm waiting on my insurance coordinator to get back with me on how to proceed, but I was hoping people on here might be able to help point me in the right direction. The date of the 39.1 BMI was in October. Would I have to wait past October of this year and resubmit so that my years would be 2012 and 2013? Thanks for any and all help!

I'm also not saying you are doomed to fail if you cheat but I look at it as something to reflect on because this surgery isn't going to magically take away my relationship with food. I've messed up, hell I got horrible news last night and went out and sought comfort in food. Am I mad at myself? Yea. Is it something I need to change? Yes. Do I think I'm going to fail with the sleeve? Not if I learn from my mistakes. I think previous comments were meant more for those who are scared about cheating the majority of their pre-op. That might say a lot about the challenges they may face later.

I think there is something to be said though about repetitive cheating. If you've cheated the majority of your pre-op diet then I think that says a lot about the challenges you are going to have after the sleeve. Those of us one the pre-op side think we know what we are getting ourselves into but until we are on "the other side" we have no idea. The way I see it is this, I not only WANT this surgery but I NEED this surgery and at this point I am willing to do what ever it takes to get this surgery done. I just received a denial on April 30th. I had already started my pre-op diet. Guess who is still sticking with it until approval? I don't have time to wait 2 weeks after approval to get this surgery done because of school. Again this is just my opinion, and I think that if people who have had this sleeve done have something to say I'm willing to listen. Will I take it as 100% gospel? No. But I will take it under consideration and try to remember WHY I'm willing to take such drastic measures. This isn't reversible and this is definitely not something I can just try out for a while to see if I like it. I am fat because I've made horrible decisions. I need to start making better decisions to not become fat again. The hunger part of the pre-op SUCKS! I felt like dying the first like week, but every time I wanted to eat something I'd drink 8 oz. Did it cure it? No, but it sure as hell helped. I'm still doing the pre-op diet and it is hard and sucks but this is a change for THE REST OF MY LIFE. 2 weeks isn't even a blip on the radar in comparison.

Exactly! Especially since you have to prove that previous dieting attempts weren't successful. Well uh duh! Here's your proof insurance! I went from 230 to 260 in less than 6 months I'd say that's a fail.

Yea I got a hold of her today. She said I'd have to write a letter and get a letter from the Dr. that prescribed everything. But its in my charts that were sent over that I was taking adipex (my insurance coordinator read it to me over the phone) so idk why I have to have the Dr. sign too but... Whatever helps me get this surgery.

Yes this is my first procedure. I did all of the requirements (3 months of visits, psych eval, nut appt. etc) They are denying me because for 3 weight out of 2 years my BMI was not 40+. I was on phentermine at the time attempting to lose weight. I guess I feel like I'm being punished for trying to lose weight.

Oh they are going to hate me lol

Thanks :-) I'm hoping its quick so I can get it between spring and summer semesters. So like next month haha

They received it on Friday the 19th. Totally tempted to call and bug them every day lol.

Mine was submitted on the 19th and Bcbs fed confirms that they received it that day. Now I wait... Should I harass the insurance company every day? Lol

Thanks!

I just finished mine on the 1st and it took from 1030 am -1 pm. I felt the doctor I went to was VERY thorough. She asked the usual questions about my support system, dieting habits, family medical history, my medical history etc. but she also asked me what I knew about the sleeve, what I knew about what to expect pre and post op, what were some if the complications that I knew about, how I planned on adapting my lifestyle after the surgery (I'm a college student living on campus so this surgery means no more meal plans). Thank God for this site! Haha I also had 5 short booklets (1-2 pages) to fill out. One was a sheet with a few sentence prompts like "Sometimes I wish" and you had to complete the sentence. All of those dealt specifically for the gastric sleeve. I also had 370 true or false questions that I had to bubble in. Like I said I felt my doctor was VERY thorough from reading others experiences on here, but I'm glad she was. I would much rather know a professional opinion on how realistically they think I'd be able to cope with the surgery and its changes than to have problems later. Just be honest and you'll be fine :-)

I'm waiting on my paperwork to be sent in, but I spoke to an insurance rep (I have bcbs fed basic) yesterday and she said it could take up to 30 days but you generally know in 2 weeks. Unless the need more records, but she said as long as you submit what they are asking for you should know soon. Good luck!

On the bus going to my last Dr. supervised weight loss appointment. Tuesday is my pysch eval (hopefully my Dr. will do it) and then I get to send everything to my Dr. for insurance approval. I'm so excited right now and really hoping everything turns out the way I want it to. Fingers crossed that BCBS Fed approves me. :-)

I've just got to pay my pcp $40 to fax the report to my surgeon and the psych eval should be sent this week. I'm so nervous

Good to know desert19! That's 1700 some odd dollars a semester that I won't have to worry about, southernsoul. Sounds like a good thing to me!

Just finished the psych eval and all those millions of bubble answer sheets. Should I be worried if the doctor said I'm a fair candidate? (not good or poor)

Sounds pretty much like what I did Monday. 370 true false questions and 1.5 hours of interview time in all I was there from 1000 am until 1 pm. To do all of the paperwork, tests and interview.

Haha :-) I feel you on fitting it into a tight school schedule, mine isn't as close together. I have 11 days in May but set up my first summer class as an online course to try and help with scheduling and healing time. My classes and the dining hall are a half of a mile to a mile from my dorm each way so I'd rather not walk that the week after surgery. Not that I'd be using the dining hall much haha

I'm hoping for a May date because of school which is kinda crazy considering its April but everything should get submitted this week to the insurance *fingers crossed* I knew going into this my mental health would present unique challenges its just kind of disheartening to hear a professional doubt your abilities. Guess I gotta prove her wrong lol

I'm hoping for a May date because of school which is kinda crazy considering its April but everything should get submitted this week to the insurance *fingers crossed* I knew going into this my mental health would present unique challenges its just kind of disheartening to hear a professional doubt your abilities. Guess I gotta prove her wrong lol

Yea tell me about it! She seemed hesitant to tell me what she thought and only did so because I asked at the end of the interview session and even then didn't really tell me a whole lot. She said she thought I'd have more trouble because of my mental health history and my family's mental health history. She said she was worried that I would have a hard time adjusting without a counselor. I have a counselor, just waiting to be scheduled for an appointment which she said was good but she said she was worried that I don't have one right now. Idk I guess I should just be glad she didn't classify me as a poor candidate?

I know this thread us almost a year old but this is exactly what I was looking for! I'm waiting for the paperwork to be sent off and now I'm worried about getting an approval but not being able to afford the surgery. I have fep blue basic. Can any one share what they had to pay? I'm hoping that by now some of you who responded may have a more definitive answer since its been almost a year. Thanks! :-)

She said I was a fair candidate and she thought I'd do ok but I would have more challenges than most who get the sleeve. Not exactly anything reassuring.