bncbabe2015

Anyone been denied so you changed your insurance? Just wondering if the "medically supervised diet" process would have to start over if I change insurance plans? That would be another longgg 6 months

Thanks for your input! This is just a very stressful time for me. Worrying about not getting approved and this and that. I may not even have to change plans. I just over analyze everything. It's hard when you want something so bad and you're scared its gonna fall through. I have blue cross blue shield of KY and as of right now, it's still a requirement for me.

I'm just looking for anyone that has any KY Medicaid plan that I could talk to?

As of right now, I have anthem blue cross blue shield Medicaid. If I don't get approved by them, I plan to change my plan at the end of the year and try another plan. Does anyone have any insurance approval success stores with KY Medicaid? I have a 40 BMI, but no major comorbidity.

Any one have Kentucky blue cross and blue shield Medicaid plan? I have several questions and need help! Please and thank you!!

See, I have been told that it would be counted as a comorbidity and I have been told that it's not "major" enough to be approved. My BMI is 41.2, but dealing with my insurance is like jumping through fire. Not only do I have to have a high BMI plus one major comorbidity, I also had to be considered at least 100lbs overweight, which I barely made the cut for. I researched and researched and researched some more, and from what I had read, if you are above 40, you have to have no comorbidity. It's all so confusing and sometimes discouraging!

Hey guys! For those of you saying you have PCOS, did it help with insurance approval for the procedure? I'm in the 6 month wait phase and need all of the tips I can get! I, too, have always been the fat one. I turn 23 in April and weighed 265 at my initial consult on March 12th. The girl that no one wanted because she is morbidly obese. I am so ready for this change.

I just started my 6 month NUT visits. Luckily for me, when I had my first appointment with my surgeon, she had a NUT there to meet with me also, so that counted as my first months weigh in. So technically mine will just be 5 months. My last weigh in will be in August. It is discouraging but also gives you time to get everything else done required by insurances. I have to have an EGD, psych eval, echo, sleep study, visit with a gyno, etc. Hang in there and know that you aren't alone!

Just wondering if anyone had been approved for surgery for having polycystic ovary syndrome?

thanks!

It's not that I WANT to be diagnosed with sleep apnea..but at least if that's what's wrong with me and I'm properly treated, I will be able to rest better! When I wake up my covers/pillows are in the floor from tossing and turning, I do not feel rested in the least. I also wake up with headaches and I could literally sleep any time of the day. It's hard for me to concentrate at work and I work at a bank so concentration is very important! Sometimes I will be asleep and the next thing I know, I am jerking and waking up! Its that "feel like you're falling off a tall building" feeling.

So today was my initial consult with my surgeon and dietician. When I first arrived, I hadn't been there 20 minutes when they told me I had a BMI of 41.7 but my insurance requires that you be at least 100 lbs overweight, also, and that I would be cutting it close. So after they done their figuring, they said I was 100lbs overweight and I just made it by a few lbs. So then they proceed to tell me that I must have a major comorbidity to go along with it and my acid reflux wasn't good enough to make the cut. It just seemed like one bad thing right after another! However, when my surgeon came in, she seemed very confident that I would get approved. They are sending me for a sleep study and she said with the circumference of my neck being 17 and my other signs, she is almost certain I would be diagnosed with sleep apnea. I really hope things start looking up for me! I was so excited going in to today's appointment but now I'm just kinda bummed and worried.

That's awesome! I have to do a 6 month medical supervised diet it's kind of bummed me out.

I know it will probably go by fast and there is several changes I need to make prior to surgery. Part of me knows it will be good but the other part of me is ready to go ahead and get rid of this extra 120 lbs I'm packing around! Congratulations! That's awesome! Let me know how everything else goes for you!

Okay so I talked to my surgeon, insurance coordinator, and patient advocate and they told me that for insurance approval purpose, they would use the weight that I weighed on my first ever doctors appointment, which was 265. For insurance purposes, I have to lose 5% of my weight during these 6 months. I guess my question is how much have some of you lost during this time frame? I'm scared to lose too much however I have to lose some or I will be denied for that reason. Help!!

Thank you! I hope I can consistently lose weight over the next 6 months. I'm ready to start my journey now(with or without surgery) but I don't want to risk ruining it for myself. How can I make these next 6 months go by quicker?!

How did it go??

Thank you so much! I always wake up feeling extremely tired and throughout the day it's hard for me to concentrate at my job because I am exhausted. I could literally sleep anytime or anywhere. Most nights, I do not have trouble falling asleep, but I do have struggles to stay asleep without tossing and turning. I hate to wish myself to be diagnosed but my surgeon said it would be the main thing that helps me. So I'm stuck between a rock and a hard place.

I went for my initial consult today. I have a BMI of 41.2 with no major comorbidities, just acid reflux. I am 5'7 and 265. My surgeon seems to think that my sleep study is going to come back with a sleep apnea diagnosis because the circumference of my neck is 17 inches and I have many of the other symptoms, daytime tiredness, morning headaches, lots of tossing and turning, etc. If you don't mind me asking, when/how were you diagnosed with sleep apnea and what were your symptoms? She kind of told me we were riding on this and that being diagnosed would be the only way to get me approved for surgery. I'm freaking out a little here!

I have anthem BCBS ky Medicaid and reading all of these posts is freaking me out! My initial consult is tomorrow..hopefully I will have better luck with them than you all!

Anyone have any information with getting approved? My initial consult with surgeon is tomorrow. I have a BMI of 41 and am on medication for acid reflux. I know I will have to do the 6 month diet and it will be a while before I have to deal with approval/denial, but I can't stop thinking about it! Any insight(preferably good) would be greatly appreciated!

My BMI is over 40, but borderline, so I'm scared if I lose on the 6 month diet like I would hope to, and fall below 40, that I will get denied and this will have all been for nothing! I have my initial consult with my surgeon tomorrow evening and I hope they can clarify which weight will ACTUALLY be used for approval. I have Anthem BCBS, anyone experienced anything with this?

Hey everyone! I have a question that I have read several different answers to so I was wondering if someone could give me a definite for this type of insurance(if possible) For approval purposes, do insurances go by your initial weight or your weight after the 6 mo diet is completed?

Thank you so much! I'm just worried about losing too much weight and my BMI falling below 40. I would love to go ahead and start losing some so surgery will be a little more easy(hopefully). But I don't want to risk getting denied.

I have my initial consult on Thursday and I am worried about the same thing. I have Anthem BCBS. Can't wait to get all of my questions answered! I hope everything goes okay for you!