Waiting A Year

[Blondie638 98]

Insurance can't approve me bc I didn't visit the doctor once a year for the past 5 years. So I gotta wait till 2014. To even submit ppwk to insurance. It's 10 k outta pocket... Anyone else in the same boat? Any advice? Kinda bummed right now :/

[smbonier 26]

What insurance do you have?

[electronicart 120]

All insurance is different. Find out what the exact policy states. Many require a 6 month supervised weightloss plan. If not, and if you have done everything your policy requires. (BMI, health issues, psyc. consult, etc.) Write a letter and tell them you are within your policy requirements.

My insurance shot me down the first time because even though I had been a member of Weight Watchers, I didn't have a record of weight ins. I provided proof that I was a member and told them I began a doctor supervised weightloss program and that I believed I was within policy. The approved me two weeks later.

[Chamie 29]

well, I was banded in Mexico. PM me for any questions. BTW- to all of the other posters, this in not a debate, just some advice.

[DELETE THIS ACCOUNT! 12,703]

Oh my goodness that's awful. I'd be upset, too.

Could your surgeon appeal on your behalf stating medical necessity? It's worth a try.

Best wishes to you.

[Darbyjack 5]

Shot down 2 times by my insurance company, even with a certified letter from my own Dr. They said I could have it done if I met with a Dr every 2 wks for a year. I even saved their letter saying...."it was their final decision, unless I presented with any further medical symptoms, that met their guidlines", so in short, if I got 'sicker' they would let me have the lapband. So, with further blood work and a sleep apnea test, i developed pre-diabetes, and had sleep apnea. Was approved in 2 weeks when sent those tests to them.

DON'T GIVE UP. It just takes a lot of hoops to jump thru, from my experience. I jumped thru all they wanted and have been banded since 10-23-12.

As suggested, make sure you know exactly what their policy is, and do whatever it takes for them. Really makes me mad that insurance companies run our health sometimes, even before our own Doc's..

Good Luck to you

[Gigi_Girl 77]

I had a year missing in the required period. My insurance allowed me to submit a picture that missing year. It is worth asking?

[Darbyjack 5]

Why not ask? Can't hurt to try. You'll never know unless you do. Good Luck

[Mayasgram 351]

I had BCBS of Michigan they required a year supervised once a month by my Dr. I was devestated cried buckets and kicked the dog (not really) but I did what they said my Dr thought it was stupid and so we met everymonth chit chatted and I got weighed. I got sicker 2 bp pills 2 asthma pills 2 reflux pills and pre diabetic sugar readings. I saw the Pulmonary DR. the cardiologist Then when my year was up and everything was submitted they said they had 90 more days to think about it. THats when I quit being pissed and got really depressed . On day 89 the Drs office called and said I was approved and when did I want my surgery. I was crying so hard she couldn't understand me saying yesterday. Two weeks later I had my band and I never looked back........ That 15 monthes was hell for me ... my Dr. was wonderful he was so angry with the insurance company calling the shots he wouldn't let me throw in the towel and quit because he felt they were hoping thats what I would do.

Looking back I believe that year was what made me so resolved to do what I needed to do to lose the weight. It was hard to wait and I feel so sorry you have to do this I would try the other suggestions but in my case it just did not work but a year is not forever and I wish you nothing but good luck and peace through this process.

[Blondie638 98]

I had a year missing in the required period. My insurance allowed me to submit a picture that missing year. It is worth asking?

Who is ur insurance thru?. And how did they know it was for that period of time?