NikiS 31 Posted October 12, 2010 Today I called the hospital to find out my next course of action. Initially I was told I'd have my psych eval and nutrition class on the same day and then a class teaching on what to expect during and after the surgery would follow...cool! Before getting off the phone I was told "I see no problem with you having a November surgery date." I felt like I was being given an all expenses paid vacation to Disney. The nurse just needed to call back with the date and time of the class that I have to take. When the nurse called back as we chatted she said LapBand or Bypass was written in my chart...NOT!!! I am not remotely interested in either of those, I want the sleeve. Second, because I don't have hypertension, diabetes, high blood pressure, sleep aptnea, etc. and my BMI is 44, she said I shouldn't be surprised if I'm turned down for the surgery. This nurse was extremely honest which I appreciated but I just wished I could have stayed on my cloud just a little longer. So now I'm off Cloud 9 and am now occupying Cloud 5...still a Cloud but just less excited. I know I could be overreacting especially since I haven't been turned down but I still feel kinda blah. Has anyone that doesn't have any other ailments, with a BMI close to mine and that has Indep Blue Cross been approved for the surgery? A little down but certainly not out, Niki Share this post Link to post Share on other sites
thickinphilly 1 Posted October 12, 2010 nikij i can honestly say i know how you feel. my bmi is higher than yours and i am a diabetic but i constantly ask myself will i go through all that i am going through and in the end be denied? this whole process is a wait and see type thing. we have set backs that we least expect. i had my upper gi and they found what the think to be an ucler so now this has be investigated on top all the other things that have to be done to be sleeved. what i had to tell myself is that we are worht it. so i know you are disappointed but i say keep pushing and if you have to end appealing several times then you do just that and don't forget your surgeon with go to bat for you as well and prove to your insurance company that you do indeed need this surgery. keep you head up and God Bless. thickinphilly Share this post Link to post Share on other sites
danitay 2 Posted October 13, 2010 curious.. were you turned down for insurance or for medical health risks???? Share this post Link to post Share on other sites
NikiS 31 Posted October 13, 2010 I haven't been turned down at all. The ball was rolling and then the nurse called with the 'things are moving a little quickly for you and I don't want to rain on your parade but just so you know a lot of people get turned down' conversation. She said because I don't have any ailments the LapBand is an option and so is Bypass, both of which I don't want. I'm hoping and will seriously pray that all goes well. Thanks, Niki Share this post Link to post Share on other sites
NikiS 31 Posted October 13, 2010 Thick, thanks so much for the encouragement. Prayerfully things will work out. Share this post Link to post Share on other sites
Maddie 9 Posted October 13, 2010 I hope it works out for you. Good job of keeping your chin up. WTG Share this post Link to post Share on other sites
sleeve 4 me 910 Posted October 13, 2010 I pray everything works out Share this post Link to post Share on other sites
Eureka-C 20 Posted October 13, 2010 I had a BMI of 47 (now I am at 44, with the preop diet) and relatively no comorbidities. My BCBS of CA did turn me down, but they turn down all sleeve requests initially due to it being "experimental". I applied for an appeal and was approved. I was very clear about why I wanted the sleeve over RNY and the lap band. It may take longer, and believe me, I know that wait is torture, but be firm in your choice if this is what you want. Make some phone calls to your insurance, read your policy, and don't give in if the sleeve is what you want. I cannot emphasize enough to do the research and be informed. Good luck. Keep us informed. Share this post Link to post Share on other sites
NikiS 31 Posted October 13, 2010 Eureka-C, thank you soooo much!!! When I met with the surgeon, he informed me that BCBS tends to turn potential sleeve patients down because this particular procedure has only been around for a few years. He also said that most of his patients are successful when they make an appeal. I'm encouraged on so many fronts. It's still easier for someone to get sleeved or at least seems to be, if you have BCBS as opposed to having let's say Atena. Also, most appeals appear to go through. Even knowing this, I never applied the latter to my situation somehow feeling exempt. I thought because everything was going along so well and so quickly that I never even considered being turned down. I'm still hopeful that I won't be, but I will do my research just in case and I'll call my insurance company to get all of the particulars. Thanks again for the encouragement. I will definitely keep you posted. Have a great day, Niki Share this post Link to post Share on other sites
NikiS 31 Posted October 13, 2010 Thank you so much. I will keep you posted. I could be getting worked up over nothing and I do appreciate the nurse informing me but I have to be honest, she did kinda burst my bubble. No worries though, I'm still pressing on. Be well, Niki Share this post Link to post Share on other sites
NikiS 31 Posted October 13, 2010 Thanks, Maddie. Silly me thinking things would continue to go smoothly...and who knows, they may. I guess I'm just anxious to begin this new chapter of my "book". Thanks for the encouragement. Let's keep our fingers crossed... Have a great day, Niki Share this post Link to post Share on other sites
dizzylizzy 2 Posted October 13, 2010 Good luck - I hope it goes well for you. I have Aetna and my BWI is actually lower than yours. However, I have a huge family history of diabetes, and heart disease, and I was told that factored into the approval. Even though I have no co-morbidities at the current time (except for borderline blood pressure issues) they probably figured it was only a matter of time. Share this post Link to post Share on other sites