Mrsace13

I am so upset. I have been calling the insurance and had a feeling this was going to happen but when I heard the word today, it was really hard to handle.:angry_smile: I called my dr office right away since they said the letter went out on Friday with the reason. My dr office said they would call first thing tomorrow and call me back with the reason and what we needed to do next. There is NO way they are going to deny me. I have read thier policy up and down and have followed everything they wanted me to do. I will fight this until I win, I can't even hardly walk due to limphademia in my legs and my PC wrote that in the letter, that should be reason enough. I can not live with this pain anymore.

Why were you denied 5 times? Were they all paper work problems? I just found out today I was declined and I will find out tomorrow why but the lady from the insurance said my BMI was 39.4 and I didn't have enough medical problems. Have you ever had any problems like that? And can I appeal as many times as I need to? I can not give up on this.

Mine is BCBS PPO OH and it does not say that I have to do the 6 months but I was denied today for not having enough medical issues I guess. We should find out why tomorrow so I can learn how to start the appeal. If your plan states you need to do the 6 months, you may not have anyway around it. Good luck.

Denied today

That is great!! I found out today I was denied, but I will appeal until I win!! lol. :wink_smile:

Thank you so much!! I went and bought it today. I'm so excited to try it. Never knew about it.

I have never seen this!! I have to go find it!! Thanks. Like someone above said, we need more and different games for the board. However, WE LOVE OUR WII FIT!!:biggrin:

I have a good friend that had GB and did great and looks great after PS. Her 21 year old son just had GB this past Thurs and he will too need to have PS when he gets done. I wanted to lose slower, giving me time to work out and pray I don't need PS. She looks great but the scars are so bad down her arms and legs. The tummy tuck ones is covered by most clothes but she likes to dress like she is 20 now and some low cut jeans show it. I read that you will lose slower with LapBand but in a 3 year time frame you would be the same as GB. The whole surgery and healing time just sounded so much better too. My friend keeps trying to talk me into just getting GB, but I have really did my homework on this and will stick with LapBand. I just can't wait to get approved, I'm calling them daily and it is stressing me out.

It hard now after deciding to get the band and Im wondering how it will be after banded. Only my co-workers know at this time and the other day we ordered Buds chicken and corn fritters. About 2 hours after eating I went to get another corn fritter and one of my co-workers (and good friend that also needs to lose weight) turns to me and asks, "what are you eating now, why don't you just pretend you already have that band?" She made me feel so bad that I threw it in the trash (I guess good thing) and said that it was cold. Then the very next day I said to my other co-worker how hard it is knowing Im getting banded soon, it is hard to diet right now even though I know I need to be. She said real smarty like, "oh yes, we have noticed that" making me feel like they are talking about me behind my back and knowing my office, they are. They have made me feel so bad now.

About 10-11 years ago and even 50 pounds lighter than I am now I was getting moved up at work. I'm a leasing agent for apartments and at this place I started out as the receptionist and I had to wear dresses or dress clothes. The leasing agents wore white logo polo shirts, pants or shorts with white shoes. So when I got moved up to the leasing agent I was so excited and showed up in shorts. I got called in after the day was over to the asst managers office and she hated saying it but the manager had her request from me that I did not wear shorts like the other smaller girls. It hurt so bad, I went home from my first day of excitement and just cried so hard. They still like to get together once in awhile for dinner and I hate going since like I said, I have gained weight. I feel like they will talk about me gaining. That is one of my reward goals too, once I look better I am going to send out an email for us to meet up for dinner. I want to show this skinny old lady my new life. She really hurt me so bad. I have had plenty of other rude things happen, but this will always stick with me. They made me feel so fat daily and I was 180 at the time!! I would love to be 180 now, lol.

I am really trying not to gain weight but I am so out of the "diet" mode right now. I really have to get on track again until my surgery. I am still pending and still waiting but I will appeal and like you said, there are plenty of conditions. Plus I found out from my insurance that my BMI was a 39.4, please, give me a break!! The insurance said their doctor was still reviewing it. I do not know much about insurance so I didn't really get that but I will call back on Monday, and Tuesday and each day until I'm done.

Does anyone know?? When they did my first weigh in my BMI was between 38-39. My insurance states I have to have a BMI of 40 or 35 or more with medical conditions. Well, after the holiday and of course I am trying not to but I am eating with the mind thought of, I will get it off after surgery, enjoy it now. So I know for a fact my BMI is now 40, I didn't mean to gain weight but I have. Do they only go by your first weight or do they look at gaining as if you meant to gain weight to get approved? I didn't know if I should bring that up to them or not.

Waiting on my appoval so it should be Jan for me too. We need a name:thumbup:

I see a lot of people saying to take at least two weeks off from work. I had planned to take off one week and then do very light work (just do paper work and stay at my desk as much as I can) do you think that will be enough time off? I'm worried now seeing the other post.

I'm 41, my highest weight is right now, I think I have gone over 230 but I don't want to get on a scale. Last time I was weighed a month ago I was 227. Not banded yet, waiting for the approval now. I know the band will not change my life problems, however I do hope it will make me like myself again. My weight bothers me everyday with everything I do and everywhere I go. I do not love myself as I should. I am so unhealthy and I can't do things I want and need to do. Even cleaning my own home I have to take breaks. At work I can't go up the stairs and breath at the same time. I feel like people are looking at me and talking about me, I hate going out anywhere with friends or seeing family. I go to work and home. I really want to like who I am and be able to play with my 7 year old daughter and my two grandkids. I live in Florida and I would love to go to the beach and not feel so ugly. My weight causing so much pain. My legs hurt from adema and I would think the pain alone would make me stick to a diet. I can't wait to be out of this pain. I know the bills and the dishes will still be there, but I also know I will finally be happy in other areas and I will then want to leave my house.

I agree, I'm 41 and I have a BMI of 38. I'm waiting for approval now and I had the same feelings. I didn't know if I weighed enough or can I do this on my own. I know I can't, I know I need this extra help. I thought about this back in Feb and then decided I could do it on my own, now 10 pounds later (gained that it is) I am so looking forward to starting a new life. This approval waiting is killing me and I know I am gaining more (I wont look at a scale right now). Good luck to you, you are so close to your new life.

I am waiting on mine now, I have B/C B/S OH. I am so worried and hate waiting. Did they tell you why they thought it wasn't? What is your BMI? Mine is a 38 or 39 in that area and I am so worried they are going to say that to me too. Did they give you any reason so you know what you need to fight back?

I don't have my date yet but I'm really thinking it should be in Jan!! I called the insurance and they said they received it a week ago. Once it is approved, the dr will schedule me in about a month so it is really looking like Jan unless I'm not approved and have to jump through some hoops too, haven't yet. DO WE HAVE A NAME FOR JAN??

This is real great info, like bringing a pillow for your ride home, things like that are very helpful. I keep telling myself that since I have done crazy diets before I should be OK after surgery but like you said, until you live it, it's not the same so that does scare me but I know I will just have to work through it. I'm glad to know upfront that I am not going to drop weight like crazy as soon as I leave the hospital, of course that is what we expect, but to know upfront the truth will be helpful. I'm glad that I have found LBT before surgery:tt1:

My dr.'s office called me last Wed and said they had all the paper work ready to fax over to my insurance. I was so excited. On Friday I called my insurance to see if they needed anything more from me. They said to call back in a few days since it takes time to get it in the system and then can take 7-30 days for approval. I called back this morning and my insurance told me they have not received anything from my dr.'s yet:mad: I don't know if I should be pushy and call the dr.'s office or just keep waiting. I'm upset they made it sound like they were sending it that day. I know I need to wait, I'm just so excited to get my approval. Of course I'm worried they will deny it then I have to fix what ever they needed and then there goes more time. Any advice? Did anyone have the same thing happen? Thanks!!

You are scareing me, lol!! I love to eat and when I'm off work I want to eat all day. I have been on some crazy diets so I hope I can handle the being hungry part.

I'm sure you can feel the port from the outside but I'm wondering can you feel anything inside of you. Do you feel it in there? When you sit, stand, walk, lay down, work out? Or do you feel normal as if it wasn't there at all? Just wondering to expect.

Are you a self pay? If not, you will need to check with your insurance to see what they require. I had to be over a 35 BMI with medical conditions. Some insurances require 40, but I have noticed most have been 35 with the medical condition.

WOW, didn't think of that area. Are there work outs that can help?

You are right, what if they sent it to the wrong place or if they were faxing it that maybe something happened and it didn't go through. I'm just upset that I thought it was there and it's not.