so worried that insurance wont approve me for surgery

[amethyst1 0]

Hi I am so worried that I wont qualify for surgery and theres no way I can afford to self pay. I have a BMI of 34. I can gain 7 lbs and I'll have a BMI of 35. I have co-morbidities , high cholesterol, depression, back pain, shoulder pain from the size of my chest 44 DDD,I'm not sure if I have sleep apnea need to be tested,I snore real loud I'm told, I'm pre-diabetic, gastric reflux, shortness of breath and all this isnt enough. My primary care physician said he will give me a letter of medical neccessity I have been to a seminar and have chose the surgeon that I want. I'm mailing the patient profile and all the other paperwork required tomorrow. I want the lapband so bad. I envy all of you that have it. Ive tried so many diets. I have never been able to reach my goal weight let alone keep it off. I keep researching weight loss surgery and decided on the band. I read all the questions and stories too. Every night I pray that I will get approved for surgery. Good luck to all of you who have the band and to those of you like myself who are trying to get the band. For those of you that have it ,you are very lucky

[Rachael 4]

Hi I am so worried that I wont qualify for surgery and theres no way I can afford to self pay. I have a BMI of 34. I can gain 7 lbs and I'll have a BMI of 35. I have co-morbidities , high cholesterol, depression, back pain, shoulder pain from the size of my chest 44 DDD,I'm not sure if I have sleep apnea need to be tested,I snore real loud I'm told, I'm pre-diabetic, gastric reflux, shortness of breath and all this isnt enough. My primary care physician said he will give me a letter of medical neccessity I have been to a seminar and have chose the surgeon that I want. I'm mailing the patient profile and all the other paperwork required tomorrow. I want the lapband so bad. I envy all of you that have it. Ive tried so many diets. I have never been able to reach my goal weight let alone keep it off. I keep researching weight loss surgery and decided on the band. I read all the questions and stories too. Every night I pray that I will get approved for surgery. Good luck to all of you who have the band and to those of you like myself who are trying to get the band. For those of you that have it ,you are very lucky

My mother in law is getting the lap band next week. She didn't have a bmi of 35 (she had a 34) either but tons of co-morbidities. She carried a weight on her to make the weight for her first appointment. I know this is dishonest but if it gives you an opportunity for a better healthier life, it may be something to consider. She has diabetes, heart disease, reflux, etc.I thought it was horrible when she did it, but I kind of understand how desperate she was. She has lost and gain several times. Or (another not so great suggestion) wear very heavy clothes, eat a heavy meal, and drink lots of Water before you weigh in with them. Wear jewelry (anything with weight), etc. I did this a few times---my first weight in with my PCP and weight watchers (when I would start and re-start).

I hope this helps. Consider the last suggestion...it may push you up the 7lbs needed without you gaining anymore weight.

Good Luck!!

*HUGS*

Rachael

[amethyst1 0]

My mother in law is getting the lap band next week. She didn't have a bmi of 35 (she had a 34) either but tons of co-morbidities. She carried a weight on her to make the weight for her first appointment. I know this is dishonest but if it gives you an opportunity for a better healthier life, it may be something to consider. She has diabetes, heart disease, reflux, etc.I thought it was horrible when she did it, but I kind of understand how desperate she was. She has lost and gain several times. Or (another not so great suggestion) wear very heavy clothes, eat a heavy meal, and drink lots of Water before you weigh in with them. Wear jewelry (anything with weight), etc. I did this a few times---my first weight in with my PCP and weight watchers (when I would start and re-start).

I hope this helps. Consider the last suggestion...it may push you up the 7lbs needed without you gaining anymore weight.

Good Luck!!

*HUGS*

Rachael

[amethyst1 0]

Thank You Racheal, thats a very good idea that I hadnt thought of I just might try that, Toni

[cat lady 10]

Thank You Racheal, thats a very good idea that I hadnt thought of I just might try that, Toni

Hi Toni: I also have a BMI of 35-36 depending on the day. I have some co-morbidities but the first time my ins denied me last summer. They said my high blood pressure was under control and therefore not considered a co-morbidity. I appealed it once last summer and was denied again. Then I got some assistance with a Level 2 appeal and they approved me last week. Hoping to get this done in July. Now that it is a reality.....I'm getting nervous. I have to repeat some testing b'cause its over a year since I did my cardiac clearance and pul. clearance. Can't believe its approved. Keep after the ins company if you get denied.......but I hope you get approved on the first go-around.

[Rainydayz 3]

Good luck to you. If your sugeon's office has a coordinator she should be the one to help you submit the paperwork and appeal if necessary. My coordinator is really good about letting me know what I need to do next and all that. Good luck to you. I hope you get approved soon!

[ElizabethNYC 1]

I just want to wish you good luck with everything!!!

[sandi2004 2]

Hi I am so worried that I wont qualify for surgery and theres no way I can afford to self pay. I have a BMI of 34. I can gain 7 lbs and I'll have a BMI of 35. I have co-morbidities , high cholesterol, depression, back pain, shoulder pain from the size of my chest 44 DDD,I'm not sure if I have sleep apnea need to be tested,I snore real loud I'm told, I'm pre-diabetic, gastric reflux, shortness of breath and all this isnt enough. My primary care physician said he will give me a letter of medical neccessity I have been to a seminar and have chose the surgeon that I want. I'm mailing the patient profile and all the other paperwork required tomorrow. I want the lapband so bad. I envy all of you that have it. Ive tried so many diets. I have never been able to reach my goal weight let alone keep it off. I keep researching weight loss surgery and decided on the band. I read all the questions and stories too. Every night I pray that I will get approved for surgery. Good luck to all of you who have the band and to those of you like myself who are trying to get the band. For those of you that have it ,you are very lucky

Be patient and think positive thoughts. My fingers are crossed for you. Lap band surgery literally saved my life! Read about it at Banded Living.

[MarcyLoo 12]

My insurance is known for denying EVERYONE! I had a BMI of 54, and went ahead with a sleep study before they sent in my paperwork (becaue even at a BMI over 50 we knew my plan would require a comorbidity). They denies me even with sleep apnea and a CPAP saying it was a "controllable" comorbidity. as I understand it many insurance co's require uncontrolled high blood pressure, untrolled diabetes, or sleep apnea as the main comorbidities. They tend not to look at others like back pain, shortness of breath, reflux, PCOS, fatty lier, etc.

Anyway we appealed the decion and were approved! Lots of denials come because they know people will give up after one try...so my best advice is to go ahead with a sleep study, get documentation of sleep apnea, and appeal appeal appeal if they deny you. (also if you do have sleep apnea you'll get a jump start on better health by treating it now...it'll lead to better healing after surgery, more energy, ect.)

[TWILLED 0]

Hi I am so worried that I wont qualify for surgery and theres no way I can afford to self pay. I have a BMI of 34. I can gain 7 lbs and I'll have a BMI of 35. I have co-morbidities , high cholesterol, depression, back pain, shoulder pain from the size of my chest 44 DDD,I'm not sure if I have sleep apnea need to be tested,I snore real loud I'm told, I'm pre-diabetic, gastric reflux, shortness of breath and all this isnt enough. My primary care physician said he will give me a letter of medical neccessity I have been to a seminar and have chose the surgeon that I want. I'm mailing the patient profile and all the other paperwork required tomorrow. I want the lapband so bad. I envy all of you that have it. Ive tried so many diets. I have never been able to reach my goal weight let alone keep it off. I keep researching weight loss surgery and decided on the band. I read all the questions and stories too. Every night I pray that I will get approved for surgery. Good luck to all of you who have the band and to those of you like myself who are trying to get the band. For those of you that have it ,you are very lucky

Hi Toni. Like you I am also worried that i will be denied by my insurance company. As of last week I have completed all the required PCP visits, testing and attendance at support groups. Now the waiting begins. My bariatric surgeon seems confident that it will be approved and said if it's not we will appeal. I'm hoping the first time is a go. I need this surgery for so many reasons. Good luck to you.

[HeatherinCA 10]

If it's meant to be it's meant to be haha

I'm not sure me personally would consider surgery if my BMI was that low... it's ALOT of work and a lot of money to lose like 50lbs

[amethyst1 0]

Hi Toni. Like you I am also worried that i will be denied by my insurance company. As of last week I have completed all the required PCP visits, testing and attendance at support groups. Now the waiting begins. My bariatric surgeon seems confident that it will be approved and said if it's not we will appeal. I'm hoping the first time is a go. I need this surgery for so many reasons. Good luck to you.

[amethyst1 0]

If it's meant to be it's meant to be haha

I'm not sure me personally would consider surgery if my BMI was that low... it's ALOT of work and a lot of money to lose like 50lbs

[amethyst1 0]

at this time I need to lose 80lbs. to be at goal,I'm 5"2"

[sandi2004 2]

at this time I need to lose 80lbs. to be at goal,I'm 5"2"

Toni - just take it one step at a time, one day at atime. I know it's nerve wracking but if you get a positive decision you schedule your surgery, if you get a negative decision you regroup and figure out how to stage an appeal. Once you've decided you want the surgery I know it's hard to wait, but one day at a time.....