Queen of DENIAL through FEP BCBS

[Callisto 79]

I am so, so, so disappointed. I started this process last December. I had to go through the Psych Eval, the three - nearly four months, of seeing the dietician, support meetings, etc. Finally the letter came back from the insurance company that my surgery for RNY has been denied. I am 4' "11' and 185 pounds or so. My BMI over 35 and I have to have at least two co-morbidities. You name it, I have it. My body hates to be fat. I have high blood pressure, sleep apnea, osteoarthritis, diabetic neuropathy in my feet, fatty liver disease, repeated issues with UTI's because of my blood sugar, I am diabetic and I know my endocrinologist is going to make me go on insulin this week - it totally sucks.

They denied me because my two years of weight history shows my BMI as under 35. I was on two different prescription weight loss pills that my Endocrinologist prescribed - of course my weight was down. However, I did not like how either of those pills made me feel. One made me feel too jittery, heart racing and unable to concentrate while the other one worked for awhile - it stopped working and made me way too lethargic.

My GI doctor was the one who told me over 2.5 years ago, when my BMI wasn't quite 35, that if I did not take the weight off that in ten years I would be looking at cirrhosis of the liver, non-alcoholic fatty liver disease. That is when my endo put me on the weight loss pills. AS usual, I gain it back. So while I am 2.5 years into my fatty liver and I am closer to the 10 year mark and my insurance company denies me.

Anyway, any tips on appealing Federal Blue Cross Blue Shield?

[LessOfMe0503 157]

Hmmmm... it may not be the happy answer, bit maybe you will to spend more time on "medically supervised" diet. Then maybe you're history would show a more problematic BMI.