MS_mom_1965

My denial was because I didn't have enough documentation of my 5 year weight history. My question is this - the policy states that I should have a BMI of 40 or greater for the five years. I do not. However, I do have a BMI greater than 35 with high blood pressure ( a co-morbidity). Is there any need to try appealing the denial? Is the 40 BMI for five years an absolute?

I had noticed someone used Dr King on another website. ObesityHelp.com and choose the forum for Mississippi.

Why is there such a difference in response times? Just on this post, we have from 4 days to over 5 weeks. Is there a different group at the insurance co for each employer?

I've told my hubby and kids that if I die in a car accident, DO NOT put anything by the road at the accident site. I don't want them to drive by every day and say, gee, there's where mom gasped her last breath. Please, remember me living!

My DH said he heard on a radio talk show that Obama's mother is white, therefore, he is mixed-race, not African-American. Has anyone else heard this?

I had BCBS until today, but I didn't have a 12 month diet history they required. Beginning Jan 1, I will have UHC, which requires a 5 year history of BMI > 40. I have a 5 year history of BMI > 35, but not 40. Does anyone know how strict they are about the 40 BMI requirement?

I see that your BMI wasn't real high when you were approved. Did you have a five year history of BMI > 40? My UHC insurance goes into effect Jan 1, and they require the five year history. I don't quite meet that.

Is there any way to check the stats for doctors as far as complications from the surgery? Both US and Mexico?

I had read this somewhere when my first child was still a baby - it certainly helps. Sometimes children will cry, whine or whatever. They will get on your last nerve. If it gets to the point you simply cannot handle it any longer, go put the child in his/her crib, then take a few minutes to calm down. Go to the other end of the house so you don't hear the crying. Take a few deep breaths. Get a drink of Water. Whatever helps you calm down. Then calmly go back and get the child, and try again. This may seem cruel to some people to shut the child in his/her room for five minutes, but it's sure better than beating or screaming at the child.

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I just wanted to weigh in here (no pun intended). I think George W is one of the best presidents we've ever had. He is not perfect, I certainly realize that, but I can't anyone would have done a better job than he has. We were attacked out of the blue (despite Clinton being warned by the CIA that cells were forming to attack the US, who did nothing to stop them), and the vast majority of the nation was calling for retaliation attacks against whoever did this. However, when the US did attack the areas believed to be involved with the cells, suddenly Bush is terribly bad for going to war. Huh? It was a no-win situation for him. Have soldiers died? Yes, it's a war. Have things gone exactly to plan? No, it's war. Bush is a God-fearing Christian who prays regularly and asks God's guidance for his decisions. You can't get any better than that. By the way, have any of you heard that the economic stats are as good or better than during Clinton's presidency? They are, but I doubt you've heard any of that...

Some insurancies do cover WLS for BMI < 40, but there's usually a requirement that you also have co-morbidities.

My insurance company covers lap-band surgery, but they require a 5 year history of BMI > 40, which I don't have. If I self-pay for the surgery, then later have a complication, will the insurance cover that? It seems like it would then be a medical problem, right?

So do the surgeons in Mexico stitch the band in place?

I took Xenical for a while, and couldn't tell it did a thing at all for me. I also tried Meridia, which made me exhausted and sleepy. I would have to come home and take a nap after work each day. I felt like I was back in the early stages of pregnancy. I also took Phentermine, and I only felt like it worked for the first week or two.

Does Dr K stitch the band to the stomach to prevent slippage?

My ins co requires a 12 month supervised diet. I don't have that. I have around 6 mos of WW is all (that I can document). The dr's office says they won't even file the ins since I don't meet all the requirements. I've seen several other posts where people have been approved since they have co-morbidities. Is my dr's office out of line? Should I contact a different doctor, or this standard practice?:cry

You didn't mention which part of the state you live in, but there are three or more dr's in Jackson. Dr Salameh in at the University, Dr David Carroll has offices at St Dominic's, but does surgery at River Oaks, and there is another at a clinic called CMMC. (I can't remember what the initials stand for - sorry).

mkcarpen, did you have the 5 year history of obesity? My insurance is changing to UHC in January. I would really like to have the surgery, but I haven't been over 40 BMI for five years, and probably haven't been over 35 that long either.

Who here has UHC? Are they pretty strict about the 5 year obesity requirement? Do co-morbidities override that? I had posted this on the Insurance thread, and I'm hoping to get more response here...

So if you have other conditions, the 5 year thing can be waived? I have high blood pressure, maybe that would count...

I currently have BCBS, which says I have to have been under a Dr.'s care for obesity for at least 1 year. I only have 6 months. My company is switching to UHC in January. How strict are they with the 5 year doctor's obesity treatment clause?

Is no jewelry at all allowed? I can't get my wedding band off. Will I have to have it cut off? I really don't want to, it's my original I was married in!

If you are nervous about it, and the nurses try to cath you before surgery, just ask them to wait until you're knocked out. They usually don't mind waiting, and you have no discomfort that way. Also, don't worry about waking during surgery. I've had two C-sections, and I was awake for both. There's a curtain so you can't see the actual incisions, so you won't see the "holes" in your body even if you do wake up.

Wish me luck! I'm told that now we have to wait to get insurance approval.