mrslong

I had not had insurance so I saw the doc pretty much just when i was sick. I talked to a differnet lady today at BCBS and she said it is not a 5 year diet it is a 5 year history of my weight loss attempts that were doc supervised.??? Isn't that the same thing LOL. She called my PCP and he let her have it, so now she is saying that i just need to resubmit everything and include a letter from my PCP and surgeon. I am also going to write one and my boss said she would write one saying that my weight effects my job(not really true but that's ok) LOL!! So we will see what they say. I have 15 days to appeal, so i will keep you updated.

They do have a person who sends everything in to insurance and deals with them. She was blown away when I called her yesterday and she deals with BCBS wy all the time and said that she has NEVER in 20 years heard of a 5 yr supervised diet. There is no real way that I can afford self pay. It is just frustrating beacuse the doctor and the surgeon both agree that I am one of the best canidates they have ever seen for the surgery. THe lady from the insurance co was so snobby and said " Well you can't just wake up one day and decide that because you want to loose some weight that WE should have to pay for your surgery!".. What??? Like I just all the sudden woke up at 350lbs and went "whoa! I had better make my insurance company pay". It is ridiculous that a surgery that is MEDICALLY NECESSARY has to be preapproved anyways. If I had a hart attack and needed a triple bypass they would pay and that would cost WAY more than 22,000 bucks. Sorry for the novel I just needed to unload.. HEHE..

Julie.. Hi I am carchasers wife and we are both trying to get the surgery.I had a question for you, did you try to fight their decision at all? The biggest thing for me is that we can't find that criteria in our policy and we had asked about a supervised diet and were told that there was none required by them, that the doctor may require one, but he doesn't. So we are just trying to figure out the next step.. Self pay or fight them. Thanks Carrie

Hi I am just starting my WLS journey. I am 23 years old and have a BMI of 55.7... I am dealing with all the insurance stuff right now. It is so stressful, but I know it will work out. I hope to get to know all of you better.. Mrs

Thanks for the reply.. Congrats on the 30 lbs you will never see again. I am excited but super nervous.. Insurance is pending so I should hear in the next couple of weeks.. Good luck

Congrats on getting your date that's awsome. I have the consult on July 8 and hopefully can get banded in September.. finger crossed. Good Luck keep me posted

Just got word from the insurance co that they do not require a six month supervised diet. I am so glad, i want to get on with this and start my new life!!

I am just starting this process and I am already annoyed. My husband has "great" insurance BCBS of Wyoming through a coal mine here.. Ha!! First I found out I had to wait a year to try and get my WLS. I understand that they consider being morbdly obese a pre-existing condition. Whatever!! I am getting close to my one year wait being over, I called the insurance company about 2 months ago to make sure I didn't have to do a supervised diet, so that if I did I could get it started. The first lady told me no, so I just let it go. Well now that I am getting really close I called again to see what all they would require. The second lady I talked to seemed to indicate that they do require a supervised diet and exercise program, but she wasn't 100% sure. So I requested a copy of the criteria for WLS so I can see for myself. I haven't gotten it yet, but I have a feeling in the pit of my stomach that I will have to do at least 6 months of diet and exercise. I am so torn up, I have dieted and exercised my brains out, but not supervised. All I have are charges to my bank account for gym and WW. I have waited almost a year and now I may have to wait till 2010 to get my band :tongue:... Sorry this is so long no one else understands, I needed to vent!!

Hi My name is Carrie.. I am just starting the process, but I am originally from Morrill, so I am hoping to have Dr. Holloway do my surgery. Hope to be talking to you..