Rena's got this

Congrats. I'm still waiting on my appeal with BCBS of Alabama. I've called my surgeon's office during business hours, but can't get them to call me back with an update. I am about to get depressed with no news....

Well, my paperwork is being resubmitted for my appeal to BCBS of Alabama. I did find that I had High Cholesterol for more than 3 years, so maybe they will accept that as a comorbidity. Keeping my fingers crossed....again.

I was denied by BCBS of Alabama because my BMI wasn't 40+ for the past 3 years, and my co-morbidities weren't on their list, or weren't bad enough. Also, my doc didn't sign the dietitian's notes on the 6 month diet that I did. That part has been rectified, and I am in the process of appealing the denial. I'm not getting my hopes up, but maybe I'll get approved somehow. My surgeon might have to get them to do a peer to peer review first.

Yes, went through the entire six months, plus the sleep study, plus the psych exam (which BCBS didn't cover). Plus a few other things such as a stomach ultrasound and gastric endoscopy which involved putting me to sleep (checking for ulcer and hiatial hernia). I am thoroughly disgusted about the amount of money I've spent so far with no sleeve surgery as an outcome. But....an appeal is in the process so, I haven't lost ALL hope yet.

Good luck you guys...I was denied by BCBS and am in the process of doing an appeal. My surgeon doesn't hold out much hope though, because my co-morbidities haven't been there for the past 3 years, and my BMI has only been over 40 this year. Looks like Mexico for me...

I've always liked bigger, taller guys....John Goodman style as someone else mentioned. Funny however, that my last significant relationship was with a guy who was only two inches taller than me, and a good 75 pounds lighter. He was a total gym rat, and even thought he was fit, he wasn't musclebound. Unfortunately he died of cancer two years after we met, and I haven't dated seriously since. But send a good large and tall man my way and I'm happy.

I like your way of thinking! I however, will be lucky enough to be spending part of the holiday with dear old Dad, who watches what I eat like a hawk, and always brings up the weight issue. If not the weight issue, then some other issue of how I could have done better in life, if I'd only taken his advice...etc. etc. ad nauseum. Meh....I'm going to let it roll off my back like water off a duck.... then when I get home I may go for one of those Mojitos!

My next step.....appeal. I've called my primary care doc and asked her to submit notes for each of the dietitian appointments I've been to. She indicated that it wouldn't be a problem. After my surgeon gets her notes, he will forward them to BCBS along with his thoughts on why this surgery is necessary for me, and if needed he would request a peer-to-peer review. So, I'm keeping my fingers crossed, and hoping I won't have to dig into my retirement funds to make the trip to Mexico.

Laura, I am an ardent admirer of your posts. You are wonderful, and you are beautiful. Why...you even have a gorgeous name. Laura. I named my daughter Laura. So don't you go on believing that dark voice in your head. Like someone else said...that voice lies. When it starts talking to you again, and it will, you've got to turn your thoughts to the truth. You are not ugly, you are no longer fat, you are wonderful. Love yourself.

Be careful....My 6 month requirement was met with a registered dietitian that was supervised by my primary care physician. My insurance (BCBS of AL) denied me, and the first reason they listed was that there were no doctors notes accompanying each month of notes by the dietitian. I had to go back and ask my doctor to submit those notes. Not fun.

Wow, you guys have gone through a lot. My hat's off to you for staying sane. My mom was great, loved her lots and just lost her this summer. My dad...well, he was mentally, if not physically abusive. I don't remember specific events because I think I've blocked them out. I just remember one where he was berating my sister. She was sharing a coke with him and held out both the can and the cup so he could choose which one he preferred. He blew up at her for not just handing him one or the other. If I remember right, he told her he hated her (among other things) during that tirade. I was furious with him for the first time of my life, but even then I was too afraid of him to stand up for my little sister. Since then, time and distance have mellowed him, and I can actually enjoy being around him again for short periods of time....who would have thunk it! And...at age 83, he still shows no signs of slowing down. I do believe he will probably outlive me. There was a time when I was sure he was going to kill me, and many times that I secretly wished he would kick the bucket. My mom eventually divorced him, but only after us kids had grown up and moved away. She was scared of him too. However, old scars didn't heal well, and I have a hard time forming and keeping relationships with men. I married at age 38 to a guy who seemed to be calm and dependable. We had two kids and then promptly all intimacies were cut off. I was ok with that for a while, then began to wonder why. Turned out that he was not attracted to women. We divorced after 11 years, and I've been alone since. All my life I've never felt truly loved by any man, starting with dear old dad, and I think that is what caused me to turn to food for self pleasure. That....and the discovery of "Second Life" on the computer. I created a beautiful avatar who was instantly able to attract any man she wanted, and it was addictive. She got a lot of attention, but I didn't have to deal with any real life relationships with all their problems. Needless to say, I spent an enormous amount of time sitting on my couch in front of my laptop, and the weight piled on. Exercise was totally ignored, although I had always been somewhat in shape before. At this point, I've been able to give up my "Second Life", although I still keep in touch with the friends I've made through that virtual world. I'm hoping that by getting the sleeve, I can get my eating under control, and can eventually start to exercise again without causing my knees and legs agony. I am wondering though, if I will ever in my lifetime find a real (non virtual) man who will love me for who I am, and..... will actually make me feel wanted, loved, cherished... all of those romantical things that I feel that I've missed out on. If not, then I guess I'll be content with being alone. It's ok, safe, but definitely not the best of all worlds.

I am also thinking about going to Cancun. After your surgery could you post your experience here? Thanks!

aww how come you were denied? My BMI wasn't 40+ over the last 3 years (yo yo dieting when I was weighed by my Doc), and the co-morbidities that they want that I have aren't severe enough. I'm appealing based on the fact that I have a number of co-morbidities that total up to a significant amount, even though they aren't all the ones they have listed. Also they said my 6 month diet didn't include any doctors notes, even though it was by a registered dietitian supervised by my primary care doc. I think my doc pulled her notes and sent them in, so that is taken care of at least!

It wouldn't bother me one bit if they did away with that 6 month diet requirement.

I was submitted on November 11th. Denied by BCBS of Alabama, and am now in the process of appealing their decision. It looks like I won't make my tentative surgery date of December 17th.

I am a yo yo dieter, and unfortunately my past 3 years history show that my BMI was between 36.6 and 41. Those times I went to the doctor and was weighed in were mainly after dieting, and didn't show me at my highest. My co=morbidities aren't bad enough for the 35 BMI, so I was denied by insurance. I'm in the process of appealing to BCBS of Alabama, but if that doesn't work, I'm heading to Mexico.

I found some at Walmart, but I don't remember the price. They didn't have much variety though.

I did it by filling a large mug with Water and ice, and sipping on it all day long. I haven't had a diet coke in nearly a year, and I was badly addicted. Still pre-op, and yes, sometimes I miss the carbonation, but I can take it or leave it now...and I generally leave it. I do have a Mountain Dew sometimes when I drive long distances...

This is what they said in their denial letter..... According to the information sent to us, the patient’s condition does not meet the medical criteria guidelines established by our medical staff for the above procedure(s). The documentation does not show a BMI of 40 or greater or BMI of 35 or greater with a co-morbid condition and on optimal drug therapy for three years. Per Blue Cross and Blue Shield of Alabama®’s Medical Policy #053, co-morbid conditions include hypertension on optimal drug therapy, atherosclerotic cardiovascular disease, diabetes on insulin or oral agents, pulmonary hypertension, or severe sleep apnea with RDI of 50 or greater. Also, the six month consecutive diet must be supervised by a practicing physician such as the primary care physician and not by the bariatric surgeon. The diet received was supervised by a registered dietician only and does not meet criteria under Medical Policy #053. Please note, letters only are not accepted. You may request one reconsideration of this predetermination. This request should be made in writing. Please include any additional medical documentation available for this reconsideration that has not been reviewed.

My surgeon put in a date of Dec. 17th, 2013, but then my insurance denied it. Let the appeals begin...

Yes... they said my BMI wasn't 40+ for the last 3 years, and although my BMI was over 35 for the past 3 years, my co-morbidities weren't bad enough. They also said that my primary doctor didn't document the 6 month diet that I did with her recommended dietitian. I should get a letter spelling everything out, then I'm going to try for an appeal. I watched "The Biggest Loser" last night and was shocked that most of the women weighed less than I did. They looked huge to me. Surely I don't look that big, so they must be awful short! Who am I kidding... I look just like them.

It took them a week and a half, but I was denied. Evidently I haven't been fat enough long enough, and my co-morbidities aren't severe enough for the past 3 years. Also my primary doc didn't document the 6 month requirement along with the registered dietitian, and they didn't like that. I'm going to appeal, of course, but it looks like it won't be this year. My surgeon's office even gave me a tentative date of Dec. 17th.

Finally finished my 6 month diet, and now the dietitian is dragging her feet in sending in the records to my surgeon. My surgeon says this is the last thing they need before submitting to insurance. BCBS of Alabama is telling me that it is taking about 30 days to get an approval, and my surgeon says that they are all scheduled up for November and December. AUGGHHHHH! I want to just go out and eat myself silly!

Found out today that I've been denied....sigh. Now comes the appeals process. I was soooo hoping to get this done by the end of the year.

Sigh....I've been denied. Now starts the process of appealing their decision. If all else fails, Mexico may be my next step. I've heard you can have the surgery by an excellent physician for less than $5,000. It is either this surgery, or knee replacement surgery in another year or two. I'd rather lose the weight and keep my knees!