angels91

I've been really stressing out the last few weeks. I am on medicaid due to medical necessity (switched from a health and wellness plan). I am up for renewal/recertification this month, and if it wasn't approved, I would lose my insurance as of March 1. I do work part time, and my income is borderline. Long story short, I called them this am to find out I was approved for next month. Now I will be able to keep my 6th nutrition and weigh in appts. It's a relief to know that the last 6 months of work have not been in vain, and I can continue on in my journey.

Unfortunately, this isn't approval for surgery yet, just annual approval for my insurance to continue. I thought I would lose my insurance do to my income being close to their limit. I'm still in the completing requirements stage right now.

For mine, I had to do two visits also. The first was only about 30 minutes or so of reviewing my life and history. The 2nd was a couple of hours of answering about 500 questions on the computer.

Unfortunately, March 30th is the soonest I can get in. They're that far out already.

My PCP and I discussed switching weight loss centers at my appt. this week. At my first appt back in October, I was told I would need to lose 66 lbs to even have my first meeting with the surgeon (have a very high bmi). Fast forward to this week. I have only been able to lose 13 lbs since October. My pcp tried to order something to help with the weight loss, but insurance denied...no weight loss supplements allowed. Her frustration, along with mine, is how much I have to lose before even meeting the surgeon. She feels that if I were able to lose that much on my own, I wouldn't NEED surgery. They called another program in our state, but I can't get in to see them until March 30th. At this time, I will meet with both the program director AND the surgeon. In the meantime, I have to continue meeting with my NUT at the current program until then. I'll have my 6th NUT visit 2 weeks before this meeting. I also have my psych eval completed. The best part is...I won't have to start all over from my understanding.

Earlier this week, I found out my insurance doesn't cover WLS, even after being told by the insurance company (prior to filling out the paperwork for the weight loss center)that if my dr got the preapproval, and then made the referral to the center, there shouldn't be a problem. Well, I called the insurance company as soon as the weight loss center informed me that insurance wouldn't cover to find out what my options were. The person I spoke to was VERY helpful. She told me I could do a medically exempt questionnaire, and if approved I would be able to get my surgery. She then said to call back on Friday, to find out the results, and that I would also get a letter early next week with the findings. Well, I am NOT good at waiting. I called yesterday late afternoon. The person I spoke to was kinda rude. She said that there was no way they could check what the findings/results were, and that I would receive a letter in 7-10 days with their finding. So, fast forward to this am. I called again. Got another very nice, helpful person. I explained the situation to her. She said it looked like I WAS approved for the medically exempt status! And that there was a letter stating so mailed out the previous day. (Which tells me the person I spoke to yesterday would have KNOWN if they had even checked.) Now it's time to wait for the award letter so I can fax it to the weight loss center and get this ball rolling! Time to take back my life!

As I stated in a post earlier today, I got the medically exempt status approved! As soon as I get the letter (hopefully tomorrow )I can fax it to the WL center and they will go from there. Then it's time for me to officially start my journey!

Just received a call from the weight loss center saying that my insurance doesn't cover wls. This AFTER my pcp called to verify it would before making the referral, and I myself calling, before I made the effort to fill out all the information and submitting it. When I initially called, they said that if my primary did a referral, then it was in fact preapproved. Today, after getting the call saying it wasn't approved, I contacted insurance again. They told me I could do a medical exemption questionnaire, which if approved, would qualify me for the surgery. So I did the questionnaire with them. She said I should know by the end of this week or early next week if approved. She also suggested I do a more in depth one through my pcp, which should help. When I called them, they were clueless as to what I was talking about. They are going to contact my insurance and get back to me. I really hope and pay this goes through, as I feel this is a life or death matter for me at this point. This weight is slowly killing me.

Oh trust me, I cried tears of joy as soon as I hung up the phone! Was just frustrated that the person I spoke to yesterday acted that way. She could have shared the news with me at that time. I realized after I originally posted that the decision was made, and the letter was actually mailed on the 25th, not yesterday (I was thinking today was 8/26 not 8/27), so had she actually checked, she would have seen the approval. But, I no longer intend to dwell on her! I'm so looking forward to starting my life all over again! Look out world, here I come!