umystifyme

I'm here!! And I am very, very happy!!!! :smile2: I found out today that my insurance company approved me!!! :thumbup: And my doctor is willing to do the surgery (he'd rather I'd do it on my own... but... he'll do it..)!!! :smile2: I am SO happy! I am SO relieved! Life is AWESOME!!! Whoo Hoo!! YAY!!! Thank you all soo very much for your support and encouragement. :wub: Without ya'll I would have surely gone insane! I definitely want to keep hearing from all of you and let you know how things are going. I just have to go for pre-op testing and schedule my surgery date. :biggrin:

I followed guidelines set forth by my nutritionist and exercised according to a regimen set by a personal trainer. Thanks! I worked really, really hard. I put my heart and soul into this entire process because I wanted to be accepted.

Waiting is the hardest part~ at least for me. I have gained 3 lbs. I am hoping that I get approved. Good luck to you and let me know when you hear something.

Thank you. I will check into support groups. I never thought about an attorney. Thanks for sharing that. I really appreciate it! :thumbdown: Amy

BTW~ My current weight is 201.2. Last month it was 203. I have PCOS, am hypothyroid, have GERD, reflex sympathetic dystrophy and degenerative joint disease in my right knee, high cholesterol and triglycerides and pericardial effusion. I also suffer from depression and anxiety. If they don't approve me, I don't know if I have the energy to appeal my case. :tongue2:

Well, BCBS confirmed that they received my documents on Sept 16th and forwarded to another department. It can take up to 6-8 weeks for them to make a decision. I did see my surgeon yesterday and I am maintaining my weight. I have other medical issues going on right now though and am very stressed. And very depressed.... I thought this was going to be a lot easier than this. I am ready to give up. All I want to do is cry. I know the insurance company has not made their decision, but I feel as if they will not approve me. I don't know why, but I don't feel very positive right now. I just wish it didn't take so long to get ins approval.

I'm keeping everything crossed!! Trying to stay positive even though I am quite impatient. The program director was unable to fax my documents to BCBS and I don't know why. And it took her 3 days to get them in the mail! :biggrin: I am sitting here biting my nails -- literally. But deep breaths..... I've come this far, so I HAVE to be patient!! I hope it is as easy as everyone says it is. She said I may have to wait between 14-28 days to hear anything from them! Okay... deep breaths AGAIN! lol I was diagnosed with GERD so I hope that will help my case. I really appreciate all the positive feedback and support! Thank you! Amy :tt1:

My doctor's office mailed my documents to BCBS for pre-determination today. I am confused about this whole pre-determination process. Is this when they either approve me or deny me for the procedure? I'm stressing... I will feel better once I understand this whole process. I will feel even better once they stamp approval on my form!!!

That's exactly my next step. I contacted a surgeon that I saw last year. So, if this isn't approved and he won't fight for me, then I will have to go see her and see what she will do for me. Thanks!

I hope it doesn't get to the point that I have to fight for it but if it does, I hope my doctor would call and do that for me. My hope right now is that I will be approved. I have to call my doctor's office tomorrow and find out how long it usually takes to hear back from BCBS of MI. I'm stressing a bit.... Thanks for your support and I will keep you all updated!!

Well... I talked to the program coordinator for the bariatric program that I went through and she will be submitting my documents to the insurance company for approval tomorrow. I asked her what she thought.... she said she has never been in this position before, as she has never seen a patient lose this much weight in the program. She said it is BCBS's policy to go by the patient's initial weight and BMI and that is how she is submitting it. All I can do right now is hope and pray. I'll feel much better once it is approved. I hope it doesn't take too long to hear back from them. Thanks for all the lovely comments and words of encouragement. It really helped me through a weekend when I was totally freaking out! Amy

Whoo Hoo!! Congrats!! That's AWESOME!! :wub:

No worries!! Thanks for the prayers!! :wub:

Thank you SO much!!! :mad: My anxiety is through the roof right now. Not only am I worried about my insurance approving this procedure, but I feel I can't talk to my doctor about it since he is reluctant to do the procedure due to the amount of weight I loss on my own. All I did was follow the diet the nutritionist gave me to a T and exercised like a maniac. I hardly thought I'd lose 20 pounds in 6 months (for insurance approval), so I tried really hard.... now I am stressing over it. So frustrating. I am working with my therapist on these issues too. It's nice to have the opinions of those who have actually been where I have been though(the dieting, weight gain, etc.). That's why I posted. I needed support of those who can relate to what I am going through-- 17 years of obesity. Thank you again!!! Now it's time for me to take some deep breaths and just see what happens. Amy

Thank you kslessar!! I'm doing this the honest way...

I have to be careful... I was diagnosed with chronic depression in December 1992. I am on psych meds and I can't lie about taking additional medication.

Or lock me in a mental institution....

Hi GraciesMom!! Small world, eh??!! My doctor did say that the insurance company goes by your starting weight and your starting BMI. HOWEVER, he did say that my BMI was under 35 right now and that at my current weight, I was not a candidate and that the insurance company COULD argue that if I lost this much weight in 6 months without the band then I don't need the surgery. My fear is that a lot of my co-morbidities went away as the pounds melted away. At the moment, I don't have any co-morbidities. Everything is under control with diet, exercise, and medication. But I did have them at the beginning of this program and during. I will have to call his office and talk to him on Monday and see if the insurance will hold this against me. I hope not. I'm really hoping and praying that all goes well and that I am approved. Please people, please.... please pray for me. I really want this "reinforcer" for life and I need my insurance to approve this. After talking to the doctor and his assistant, my documents will be sent in for approval. This is driving me crazy!!

I totally agree with you. I have been in psychotherapy on and off for almost 17 years. I have also been on medication for depression and anxiety for almost 17 years. In 17 years I have proven that I am a life-long dieter with a lose and regain cycle. The medication and therapy has not helped with my weight loss obviously. I really do appreciate everyone's comments and opinions. I was looking for some other view points and I got them. And I am glad that I did. I realize now that I am making the right choice by going ahead with the surgery... keeping everything crossed that my insurance will approve me!! Thanks again!! :frown:

I have high cholesterol and high triglycerides, even on medication. I did have a fatty liver until last month. My family practitioner is well aware of my history of weight loss and weight gain. He's seen my struggle with weight for over 11 years and is behind me 100% on the surgery. Thank you for the information. I truly appreciate it! :w00t: Amy

My current BMI is approximately 34. Co-mobity's??? I'm not sure of. I'm sorry... what would those be??? I had a lot of health problems when I was heavier, such as a fatty liver, but that has resolved itself with weight loss.

I have tried tons of diets in the past and have always given it my all. I am always successful in losing weight but always gain it back plus some. I definitely can lose weight with diet and exercise alone but I always regain it. And now I have more health problems.

Any advice would be helpful. I didn't plan to lose this much weight. I just followed the nutritionist's diet and exercise plan and it came off....

I am 5'4" and my starting weight was 285. I am now 203. I lost 82 pounds in 6 months with diet and exercise. I'm afraid my insurance company will not approve the surgery because of my massive weight loss. :thumbup: