question on insurance

cyndilou29 · January 16, 2007

I know many of you had to go through many appeals to get this done. I have been told by my insurance that my employer excluded it from coverage. My question is this: what happens if I lose some weight in the interim? My highest was 241, currently 231 but what happens if I lose, say 20-30 lbs and my BMI is no longer over 40? Do I not qualify if I win the appeal now? I am not well and cannot stay at this weight (pre-diabetic, high cholesterol, GERD, sleep apnea, multiple sclerosis) but I don't want to eliminate myself from this surgery altogether. I am at at BMI of 40.2 right now.

Why is this so hard? When will people understand this is a health issue and not a "character" issue?

cyndilou29 · January 21, 2007

When you guys went through it, was it your initial weight that they looked at or the weight just prior to surgery. I am literally at a BMI of 40 right now. 1 more pound loss and I don't qualify.

anonemouse · January 21, 2007

I have been told that if you are appealing because of an employer exclusion, it is almost impossible to win.

GoddesPotential · January 24, 2007

I, sadly- very sadly, would have to say that if you are losing weight (and that is a considerable amount, not just 2-7lbs) than some would tend to think you CAN do this without surgery. I am not at all suggesting you quit losing, just pay close attention to the facts. If you are like me, you have lost weight before and it will more than likely return. Do you want to keep yo-yo'ing on the diet torture or do you like most of us here see this as our FINAL opportunity to be "normal" and not have to sleep/eat/drink our addiction constantly- thinking about whether or not you should have had that last piece of bread or a glass of wine??!

All I hope is that if you can lose this weight w/out the surgery AND KEEP it off- than you should continue losing it naturally. If you know better, than you have to make another choice - stop losing weight??

I wish you all the luck in the world, I feel your plight!!

cyndilou29 · January 29, 2007

I, sadly- very sadly, would have to say that if you are losing weight (and that is a considerable amount, not just 2-7lbs) than some would tend to think you CAN do this without surgery. I am not at all suggesting you quit losing, just pay close attention to the facts. If you are like me, you have lost weight before and it will more than likely return. Do you want to keep yo-yo'ing on the diet torture or do you like most of us here see this as our FINAL opportunity to be "normal" and not have to sleep/eat/drink our addiction constantly- thinking about whether or not you should have had that last piece of bread or a glass of wine??!
All I hope is that if you can lose this weight w/out the surgery AND KEEP it off- than you should continue losing it naturally. If you know better, than you have to make another choice - stop losing weight??

I wish you all the luck in the world, I feel your plight!!

Thanks Goddess. I figured the same. I can always lose weight, I just can't keep it off. I have lost over 500 lbs in my life (not all at once!) I just go up and down, up and down. So frustrating. I think I'm going to just maintain for now until I find out for certain if this is going to happen. Thanks for the feedback.