I need to vent!

[short1 2]

Last night I went to a seminar put on by a Dr. from Bloomington IN. I wish I would have never gone. My Dr. is in Indianapolis, but I thought maybe I could learn something new from this guy. He said Indiana law requires everyone to go through six months of Dr. supervised weight loss. He also said if you gain weight you may get turned down. I challanged his statement and he stuck to his story. Needless to say I was upset. Evidently I had nightmares and kicked the crap out of my husband to the point he had to get up. I know six months is not a long time, but I have already been waiting three months and want to do this so bad. I callled my Dr. this morning and they calmed me down. They said it is Indiana law, but the insurance decides who does what, and that I more than meet the guidelines. I just don't trust anyone now. I have scheduled an appt. with my dietician to be on the safe side. I just want someone to tell me the truth. The waiting is killing me!

[faithmd 14]

I am sorry you are so upset. I would advise you to call your insurance company TODAY, right NOW. Ask them what your specific requirements are and then ask them to email AND snail mail them to you. You need a copy in hand. Also ask your INSURANCE company if they are strict about waiting the full six months. If they are, then use that six months to get your head straight, practice eating in a bandster way, practice chewing, chewing, chewing. Start not drinking with your meals. You can use the next couple of months to make sure you are completely successful after banding.

Take heart, I had to wait 15 MONTHS.

[short1 2]

Thanks Faith I am on hold with them now. I will start practicing withthe chewing as well. I tend to be a gulper.

JP

[susaninnkc 0]

My insurance required that you had to be on a diet supervised by a doctor for a year. I didn't believe them, so I had them email every requirement to me and I gave it to my doctor. But fortunatly I got around that since I have very large hernia. But I was watching "Big Medcine" on TLC last night and this women got turned down by her insurance because she wasn't losing the weight before. And that is one thing the insurance compies are looking for is to see if you are comediate enough to lose the weight. My doctor explained it to me the lapband will only help a little bit but 70% is on how you do.

good luck with everything. and keep us updated.

[faithmd 14]

Yep, I was denied the first time I applied because I hadn't lost the 5% required by the insurance company during the one year diet. I did have extenuating circumstances (heart issues) and was put on meds that made me gain a lot of weight. They didn't care, I had to lose back to my starting weight (that I started my one year supervised diet with), PLUS the 5%. Damned insurance companies. I'm fine with requirements, but if I have documentation of why something wasn't followed, then why not accept it?

Oh well, it's done now. Banding on Thursday!

[short1 2]

I don't have a problem with the supervised diet, I have a problem with them changing the rules daily. I simply want the truth.

JP

[faithmd 14]

So what did the insurance company say?

Who is changing the rules? Try to sort out the BS from the necessary information. I know it's tough sometimes and really freaking confusing. But if you are going to have the insurance pay, then that is who you need to believe. They are the ones who will or will not cut the check. The MD's office can tell you what the USUALLY see, but the final say so comes from the insurance company. And please remember to get it in writing, and write down the names of everyone you talk to, the dates and the times. If there is a six month diet requirement, make your appointments now for once a month to see your PCP or whoever you need to see to supervise this diet. Don't miss a single one! You'll have to start at square one.

[GayleTX 1]

Sounds like he's telling you the truth (and why would he not???)

I found this when I googled.....could get it to copy since it was adobe but here are the links.

PDF]

A Patient’s Guide to Advocating for Improved Access to Weight-Loss ...

<TABLE cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD class=j>File Format: PDF/Adobe Acrobat - View as HTML

Accessing Weight-Loss Surgery in Indiana. Access to weight-loss surgery is mandated by Indiana law (Indiana Public Law 196). The mandate ...

www.obesityaction.org/advocacy/<WBR>Advocating%20for%20Improved%20Access%20to%20Obesity%20Management%20Service... - <NOBR>Similar pages</NOBR></TD></TR></TBODY></TABLE>

[PDF] The mission of the Obesity Action Coalition is to elevate and ...

<TABLE cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD class="j hc">File Format: PDF/Adobe Acrobat - View as HTML

As you may be aware, insurance coverage of weight-loss surgery is mandated by Indiana law (Indiana Public Law. 196) and the OAC strongly supports this ...

www.obesityaction.org/advocacy/<WBR>Indiana%20-%20Governor%20Daniels.pdf - <NOBR>Similar pages</NOBR></TD></TR></TBODY></TABLE>

[mylap-band 0]

visit

GO LAP-BAND

They have all the answers for all your questions, i had mine done and i'm so happy they are the best

[short1 2]

Thank you to everyone. It is so nice to have people who care. I have already weighed in two times and have the third one this Friday. No one has told me to do that for sure, but I thought in the beginning I should be safe. Now if UHC would admit to having my paperwork I will calm down. Thanks again and good luck to all.

JP

[libra 13]

It really depends on your insurance. Many do require a medically supervised weight loss program before approving your surgery. It's good advice to check with your carrier.

[short1 2]

Well I have good news. My secondary insurance BC&BS has approved me as of today. Now all I have to do is to get the primary UHC to say yes or no. I don't even care at this point, I just would like for them to admit they have the paperwork. I will keep everyone posted.

JP

[ginger205 0]

Well I have good news. My secondary insurance BC&BS has approved me as of today. Now all I have to do is to get the primary UHC to say yes or no. I don't even care at this point, I just would like for them to admit they have the paperwork. I will keep everyone posted.

JP

Congrats to you! You are on your way know! Just keep telling yourself, all these things are just 'bumps in the road" to your new life!!!

Banded 5/4/07

[cmaiorano 0]

I guess Indiana likes us big folks. How can a state make a weight loss law? This is crazy. Go somewhere else and have the band completed.

[derbygirl 0]

You should just be happy that it's covered. I don't mean to sound bitter but some of us didn't have any option but self-pay. You're lucky.