Need some input please!!!

[WillPower 0]

I am trying to get the approval to be banded. I think that I am going to get the run around. Has anyone had to do a 12 week supervised diet? To be approved for surgery. Now there are telling me that I have to have a Psyche Eval. I am going to have to change my life, I am going to have to control my eating,,,, NO SHIT! I would not be doing this if I could be trusted around food!! My stomach is like a dog, if it is not on a leash it will run and run and run........... They are also trying to tell me that my BMI has to be over 40. when I am at 37.8 right now. I think that this is going to turn into a horror story, maybe I should just give up.

[Penni60 45]

Jack I have PacifiCare insurance as well. I am now in the middle of filing to see if they will reimburse me for the initial surgery. SUCH A HASSLE.

Willpower: it is a battle to get the insurance co to even talk about the lap band. So hang in there. There is always self pay as an option.

[Alexandra 55]

Will, what you're getting is not the runaround. It's normal procedure for any insurance carrier being asked to approve an expensive surgery.

It seems insurmountable when you see the list of requirements from either a carrier or the doctor for the first time. I'm sure things will look different to you in the light of day, when you have a chance to really look at what they're asking for and see how easy it will be for you to provide it. Look at it this way: They haven't said no!

Stick with it. If you know this is the right thing for you, it will still be the right thing a year from now and no less effective for the wait.

[leatha_g 4]

I am trying to get the approval to be banded. I think that I am going to get the run around. Has anyone had to do a 12 week supervised diet? To be approved for surgery. Now there are telling me that I have to have a Psyche Eval. I am going to have to change my life, I am going to have to control my eating,,,, NO SHIT! I would not be doing this if I could be trusted around food!! My stomach is like a dog, if it is not on a leash it will run and run and run........... They are also trying to tell me that my BMI has to be over 40. when I am at 37.8 right now. I think that this is going to turn into a horror story, maybe I should just give up.

This is absolutely nothing new or unique. My brother and his wife were put off yesterday with the directive to have 1 YEAR supervised weight loss program with their doctor. Now is the time to get your ducks in a row. Do the 12 week supervision, get your appeal letters ready to go, see the psych (we all did) and anything else they want. This is very common. Your reaction to it, however, may be the clencher.

[momhappe1 0]

I could swear I posted to this earlier today, not sure what happened.

My BMI was under 40 and I was declined by my insurance company. They will not approve you unless you have a comorbid disease if you are under 40. I did not have all of the usually one's so I had a sleep study done. I have sleep apnea ( there is a very good chance you will have it being over weight) and after I sent in those results they approved me within 2 days.

As for the diet, have you even been in weight watchers? If so does your doctor know it?

You will have to do the phyc eval we all had to, however if you really want this you are going to have to work for it. It took me a year to get this done. I am a single mother and there is no way that I could have afforded this on my own.

If this is something you really want you are going to have to work for it. I went through appeal and all of the above, but it paid off and this surgery only cost me 250.00 plus co pays to the doctors. Now if I add in the co pays for everything else including the sleep stuff and my CPAP I will be in about 1000 over the last year. The way I see it I will save that in food the first few months.

Good luck with your soul searching to see if this is what you want.

[New Hope 37]

You won't know until you try! I was denied, appealed, 8 months later got my band, w/several co-morbidities. (You should see what you have to go through for a kidney transplant!) Best of luck to you!

[nightingale2u 42]

Willpower... I understand your frustration but as the other members mentioned... you are going through a very normal part of the process to be banded. I think that the only way to avoid the hoop jumping is to go to Mexico and pay for the surgery privately. Hang in there... this is a great forum and everyone here will support you as you go through the process.

Darcy

[blossom 2]

Wow, I posted to this earlier today, and now my post is nowhere to be found.

Anyway, WillPower, as someone else stated above, now is the time to get your ducks in a row. Just do the best you can on the diet and try not to get down. Document everything: weightloss history, request old medical records (especially if you had dr managed weightloss), medical history, family history of major issues such as heart disease... Get yourself prepared for a fight (hopefully you won't have one), find out what your insurance appeals process is. You can do this, I know you can! Be strong and stand up and show those SOB's what you're made of!

[WillPower 0]

I did talk to my GP and he said that with my blood condition it would be easy to Creatively mark it up to make it look like a diet program...I had my best blood test ever last month too!!! Plus, the fact that I have been on Xenical and Meridia for a couple years helps too. I know that it is wrong but, so is making me jump through hoops that I can't get through because I am to fat!@!@!

Thanks to all of you for your input!!!