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In like Flynn...NOT!



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I had everything set....then I got the call on December 23rd. My insurance denied my request for Lap Band surgery. When I first started this journey, I specifically asked my coordinater if my insurance required the 6 month monitored diet plan, and she told me that my insurance only required a 5 year weight history from my Dr. So, that is what I provided. I had just recently met my minimum deduction amount of $1,500 by getting all of my pre-surgery procedures, tests, and pych eval. Now they tell me I have to do a 6 month diet program. My coordinator says that since I saw the Dietician on Nov. 11, that we can go from that date.

My insurance starts for the year on July 1 and goes through June 30...

I hope I can get this done by May 11, then have surgery by June 30. Boy, talking about cutting it close.

I just wanted everyone to know that "timing" is a big factor...so if you don't have the money and are relying on insurance; start as soon as possible when your insurance goes in affect for the year. Plan, plan, plan. And it may be a good idea too, to get the requirements from your insurance directly. I found out that my insurance plan changed Nov. 1, 2013. My first appointment was Oct. 31, 2013 with my surgeon and the coordinator....touche!

Good luck to everyone!

Stay strong and vigilant for your health and happiness. This process is hard, but I know it will be worth it.

BTW, my insurance is United Health Care.

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i am so sorry everything didn't go as planned. but you can use this time to train yourself. like using a saucer to fix your meals on. eat no more than a cup of food at a time. chew slowly, chew alot, and eat just little itty bite fulls of food. eat Protein first, vegetables second, carbs last. get your cupboards cleaned out and stocked with liquids and mushy food. take 20 min's to eat a meal. so much you can do since you have the time. good luck

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I agree, take this time to train yourself using smaller plates, eating utensils and portions. while I was on the 6 month plan, I started using dessert size plates and the smaller forks. when you use a smaller plate, you don't feel like you are being cheated

out of food as the smaller plate is filled. Best wishes. Karen..aka.kll724

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Boy, talk about timing -- pretty amazing the way that lines up with the insurance year. Know that you are going to be there before you know it. I had a five month wait and used that time to read posts and learn all I could here. Plus I got a therapist to address those food issues once and for all. I'm 52 so it's not like I hadn't worked on this before, but since I was getting a band it felt very different. I was able to cop to the ways I used food to soothe myself, quell anxiety, reward, etc. I really worked on breaking down the why and when of eating and found those triggers. Without the band I wasn't really able to override them -- at least not all the time -- but I was doing the important part, the noticing. So take this time to notice what you do. Do you reach for food when the phone rings or when you have the house to yourself or when you're driving, etc. Write it down, analyze it. Have the scone if you want it but know that there's a reason you're doing it -- figure out what that is.

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I also have UNHC and I know there are different plans out there and what is true for one might not be for another....

I had to do the 6 month thing also, but since I see the Dr. often for well check ups and sick visits etc. Each time they ask me to step on the scale. So I had her use those weights, fill out and sign the work sheet for the insurance company and that was acceptable.

If you are anything like me the whole time you have been seeing your doctor you have been on diet after diet all of them supervised by your doctor who takes care of you. That should count....if you can coordinate those weights and dates, and your doc will sign off on them and maybe you can shave a few months off and get in under the annual insurance date.

Best of luck to you!

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Thank you all for your words of encouragement. Terry, you are right about that...I have already been shaving off my portions, and as I am a former Atkins loser, I still usaully choose Protein first, then veggies/low glycemic friut and then carbs...trying to stay away from white four and processed sugars/foods. I do need to work on the smaller bites and chew really well.

Bandista, thanks for the reminder to get my head on straght and deal with food issues...that wiil be a life-long battle, but I will have a headstart and an easier time sliding into the routine.

I really need to start exercising again, I miss it! It is just hard to get started. I know how much better I feel when I have less weight on my frame and I'm active.

Lisa, thanks for your information. I thought I was good-to-go, because I did have close monitored weight/diets with my pcp, but the last time I lost was 2009, losing 95 lbs by fall of 2010 and somewhat kept most of it off for about, 18 months. I ended up getting a job Feb 2012 after being laid off for a year, and I was a full time student with a toddler. I gained it all back by December of 2012 because of lack of excercise, time, and of course eating quick easy aleady made food.....processed, bleckh! I miss how I felt, even though at 245 lbs, I was still considered morbidly obese. I was a healthy 245. OK...now I'm babbling, but the point is, I thought that weight history would suffice, but it wasn't "current" enough for UNHC to give green light.

I'm really not too upset, except a little freaked out about not getting the surgery in time to be 80% covered because I have paid everything in-full to date to meet my deductible. I wanted other people to be aware that if they decide to do this, it is a lengthy process, and as you veterans all know that you need to stay up on everyone working your case....stay in contact and involved with your process. Besides, I beleive that things happen for a reason...I am taking this as just that.

Again, thanks guys for being here...it's nice to have this support. I have learned a lot from you this and other sites.

;)

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Just make sure your coordinator knows what your cutoff is for your deductible so they can schedule you and get your approval in on time

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