Justine13 264 Posted July 25, 2012 I suddenly feel hopeless. Sometimes reading the difficulties is hard because I don't want anymore road bumps- I had enough. My hopelessness is because during my 6 month requirement I have done nothing but gained weight. My PA is telling me not to worry about it and she has seen this before. That is the only thing my insurance required. The program put me through other testing including psychological which I passed. I read it actually. I said I am likely to follow through with Dr. recomendations after surgery (however unlikely to follow an exercise routine. Duh- I have said that since day 1- I hate exercising- traditional exercise anyway. I like swimming- playing softball- walking with friends and even love lifting weights. But put me in a gym- no thank you). Anyway- I'm really trying to hold on to my doc's words but it's hard when i read all the stories of denials on here. Need positive thoughts............. Share this post Link to post Share on other sites
bmooney364 30 Posted July 25, 2012 Do you qualify according to your ins. company guidelines? If so it should be fine. Hopefully you will sit down with the person who sends the info to the ins. co. and you can make sure everything is included to help you get the surgery. It seems like it takes forever, but your time will get here. I am glad to tell you alot of people gain wt. (myself included) during the 6mo requirement. It just shows that it is hard for you to lose wt. and if you are like most of us, if you did manage to lose a few pds., you would quickly put them and more back on. One more thing, denial is not the end of the process. I was already thinking out my appeal before I got the approval call. LOL. Good luck to you. Share this post Link to post Share on other sites
O.T.R. sleever 3,386 Posted July 25, 2012 Yes, there are a few denials on here, the real question is what are your ins. co. requirements? Do you meet them? Most often denials are because of lower BMI (under 40) with no co morbidities. Or in many cases I've seen here WLS was specifically excluded Share this post Link to post Share on other sites
Justine13 264 Posted July 25, 2012 Do you qualify according to your ins. company guidelines? If so it should be fine. Hopefully you will sit down with the person who sends the info to the ins. co. and you can make sure everything is included to help you get the surgery. It seems like it takes forever, but your time will get here. I am glad to tell you alot of people gain wt. (myself included) during the 6mo requirement. It just shows that it is hard for you to lose wt. and if you are like most of us, if you did manage to lose a few pds., you would quickly put them and more back on. One more thing, denial is not the end of the process. I was already thinking out my appeal before I got the approval call. LOL. Good luck to you. All they require is 6 months consecutive professional documented weight loss program. no requirements on if I have to lose or not so maybe you're right. Thank you- That was helpful. I will say I'm trying more now that it's closer. I gave up pop and Breakfast time I'm trying to watch my carb intake and also drinking much more Water. The weather has been horrific (Heat is bad) so no walking. I just dont' want to gain at my next one. Thank you for the validation. I truly am freaked out about this now. These days are going to go by so slow Share this post Link to post Share on other sites
Justine13 264 Posted July 25, 2012 Yes, there are a few denials on here, the real question is what are your ins. co. requirements? Do you meet them? Most often denials are because of lower BMI (under 40) with no co morbidities. Or in many cases I've seen here WLS was specifically excluded Ugh-good to hear as well (well not for those individuals). The only thing I'm nervous about is the constant weight gain. But then I think "r u serious? If I cold lose it I would". Don't want to wait anymore :( Having a bad day/night with this. Thank you as well for your support Share this post Link to post Share on other sites
newgrandmother 725 Posted July 25, 2012 i am there with you. you are not alone 1 Justine13 reacted to this Share this post Link to post Share on other sites
IMSKINNY 160 Posted July 25, 2012 I totally feel your pain. After 90 days of mostly 2 Meal Replacements a day, I had a loss of a whopping 1 lb. How old are you? I'm convinced that I have reached a really bad hormonal place because I am 45 and looking menopause square in the eye. I just can't seem to lose. Although I didn't really lose during the diet, I was approved. This has been hard, so I know what you're saying! Share this post Link to post Share on other sites
mrsjones075 40 Posted July 25, 2012 You are definitely not alone. I'm 3 months into my 6 month supervised program. I am terrified that I will jump through all the hoops & still be denied. 1 Justine13 reacted to this Share this post Link to post Share on other sites
Justine13 264 Posted July 25, 2012 I totally feel your pain. After 90 days of mostly 2 meal replacements a day, I had a loss of a whopping 1 lb. How old are you? I'm convinced that I have reached a really bad hormonal place because I am 45 and looking menopause square in the eye. I just can't seem to lose. Although I didn't really lose during the diet, I was approved. This has been hard, so I know what you're saying! Thank you- I'm 36 but I also have some auto immune stuff going on which really causes extreme fatigue. I don't want to blame that because that's not it totally but it certainly has been the reason for my recent weight gains. I'm SO happy to hear that you were approved. Bah! This is NOT fun. Thank you again Share this post Link to post Share on other sites
Justine13 264 Posted July 25, 2012 Thank you to everyone - it means the world to me to be a part of this. Really- thank you!!! 1 Giselle3264 reacted to this Share this post Link to post Share on other sites
Justine13 264 Posted July 25, 2012 OMG I'm 37! I totally had to ask my family- oh oh 2 Heyher and cmf1267 reacted to this Share this post Link to post Share on other sites
cmf1267 27 Posted July 25, 2012 OMG I'm 37! I totally had to ask my family- oh oh Wait til you hit your mid 40s - memory gets even worse. Just something to look forward to, but at least by then - you'll have lost all your weight. 1 Justine13 reacted to this Share this post Link to post Share on other sites
bmooney364 30 Posted July 25, 2012 Just another thought if you were very successful with the 6mo wt loss program what would happen? Would they declare you a wonderful wt loss success story and therefore, you don't need wt loss surgery, because you are able to lose the wt without the surgery? I know most of us on here have been on every diet available and have lost lots of weight ,but it is keeping it off. Most of us can not do it and yoyo up and down until our metabolism is wrecked. This is just me, but that is the reason I wanted the surgery. Share this post Link to post Share on other sites
New1 201 Posted July 25, 2012 I lost weight on the 6 month diet the first 4 months and then spent the last two months gaining most of it back prior to being approved by Anthem BCBS. Keep hope alive! Share this post Link to post Share on other sites
newgrandmother 725 Posted July 25, 2012 i felt that way the other day it will past. just think this time next year we are going to be talking about all the new cloths we bought 1 Justine13 reacted to this Share this post Link to post Share on other sites