kayel8ch

I need to quash my 2-liter a day Diet Coke habit. Need suggestions. Is diet Iced Tea allowed? Or maybe as a stepping stone? Help.... Please

I was doing very well! But got derailed this week a little. Not too bad, but I couldn't take the headaches, so I gave in. So this week I've had, 2-20 oz bottles and 1.5-2 liters. Still much better than before. But still have a lot of work to do. Doesn't help that I have the stomach flu now, day 3. Ugh!

Pretty proud of myself! Doing well. Started at 2-liters/1.5 days. Down to 20 oz/1.5 days! Using Diet Snapple and Crystal Light to help.

I have BCBS NJ, they would not provide me with hard copy of the policy requirements, I had to write them down as they read them to me. However, I had to submit the required documentation to my husbands union benefit office, then it goes to a review board to prove medical necessity. Then to the board of trustees to decide if they are going to open up my benefit. Then the trustees tell the insurance company to pay for my surgery and hospitalization. Quite a circus. Been working on this since December. And still have another 6 months of the supervised weight loss, before resubmitting. And waiting....

Just talked to program coordinator, I CAN do my 6 months supervised weight loss with my PCP. But I would still need to see they're dietician for 1 visit and pay $175 out of pocket. Then they include the psych eval at no charge. Big relief! Once I satisfy those 2 things, the union will open my surgery benefit! Such a pain in the butt! 8 months working on this, now another 6 more!

That's fabulous and encouraging! Thank you! That was another question. My start weight is 260, BMI 41, with 3 co-morbidities. If I do we'll doing the 6 month diet, they're not going to be like oh well she can diet and lose the weight, and deny me? Been hit by like 3 walls already, so upsetting when they call me and say well there's a problem... Etc.

I just got off the phone with the union, and they said that I can do my 6 months with the PCP, but it must be consecutive! I didn't have consecutive before. And then I would need my psych eval, which is $500 btw. Then resubmit. Now if I do the requirements for the insurance I'm ready to go. BUT then what about the bariatric program requirements. Would I need to satisfy that also? Guess I need to make some more phone calls.

I also have BCBS, I guess every "branch" is different. Plus my husbands union benefit fund is in control of the insurance and what they provide. So from visit one, until the surgeons office feels I am ready for surgery will be cash out of my pocket. Just feel like I've lost the last 8 months. And now have to start over because of the 6 months thing. So annoying! Just want to be pain free and play with my 1 year old without being short of breath! So what happens if we actually do well during this 6 months diet and lose say 20 lbs, and now I'm no longer in the BMI range? Then what? They won't cover it because I did so well? Anyone have this happen?

Thank god someone else is going through the same crap I am. I have been working on this since December. I went to my info session, first appt with dr and was given my surgery date, about to go do the psych eval and the dr office called me, the insurance excluded bariatric. Now I'm pissed, I called the insurance company 3x prior to info session and no one told me it was excluded. I got ahold of benefits coordinator at my husbands job to get more info. I found out that the union will open up the benefit as long as I submit an appeal with all the criteria. The 6 months diet, all my paperwork, etc. I collected everything and sent it in a binder with tabs... And... They denied me. I need 6 consecutive months with the bariatric team NOT my regular doctor, and the psych eval. Well they never told me that! So now I have to do the ENTIRE program, SELF PAY. Then submit everything again. And they MAY approve me to open the benefit to pay for the surgery and hospital stay ONLY!!! Ahhhhhh! Soooo want to scream! Sorry so lengthy, needed to vent!