insurance

christinev · August 2, 2007

I have just received paperwork to fill out for the seminar I am attending on Aug. 30th. It asks me questions like how long I have been over weight, What programs I have tried, The reason I am asking for the lap band. I am afraid that my reason isn't reason enough. I totally hate the way I feel, look. I have never been this big and I have been this size for about 1.5 years now. It seems like just diet and exercise doesn't work anymore. I can't move the way I used to. I can remember being in 2nd grade and going to the doctor to have my thyroid tested. I have always had issues with weight. Can anyone help me with these questions?:think

ChloeH · August 3, 2007

Hi Christine,

when I filled out forms with my reasons for getting the band the social and mental health aspects were my main reasons. There were frequent occasions where I didnt go out because i just looked disgusting and I have always had thin Gorgeous friends to compare myself to.This lead me to a mild depression that has followed me since I hit puberty & started getting bigger. if you express to your surgeon how being heavy effects your life it should be reason enough.

I really hope your surgeon is as good as mine. Im 4 days post op and lost 2kg and although the first few days were bad i can already feel how good this will be for me.

I think people like us just dont have the motivation or commitment for diet and exercise to work so this option makes it alot easier for us.

Good luck with everything keep me posted on whether or not you go ahead with it.

From Chloe

christinev · August 4, 2007

Hey Chloe, Thank you so much for the info. I also put down the times that I did lose weight but gained more of it back. Through diet and exercise and pills. But I also said that I am unable to be that physical now because of my weight. I put down that I have foot pain now . I can't walk far anymore. They also ask if I ever had an eating disorder. I used to make myself throwup years ago and a few times over the past year...should I put that in there? I don't want to put anything down that might hinder me from getting this surgery. I am very depressed about how I look. I am at my highest. I can remember getting looks from guys as they would go by. Exchanging smiles and flirts... A few years back I went down to Camp LeJune to welcome my cousin home from Iraq. Hell, I smiled at some guy that had just come home also and was staying at the hotel with his family. He ended up asking me out on a date. I was there for all of 7 days. Now...nothing. It really sucks. I will go over more of the questions...maybe you can help me. Thanks Chloe.

Christine

ChloeH · August 4, 2007

it sounds like you have way more reasons listed than i did on my forms. I think list anything that being overweight has caused problems with in your life. I was the same lost a lot of weight on a pill felt all good looking and got looks from guys and then it was all back on again probably lost and gained my weight again about 4 times before I gave up. My mum had the lap band 9 years ago has lost 40kg and is the happiest shes ever been if she hadnt of had it i wouldnt have known about it and have it now and would be miserable still.

keep me updated on any other questions that worry you.

from chloe

Alexandra · August 4, 2007

Hi Christine,

The fact of the matter is that insurance underwriters really don't care how we "feel" when they're making coverage decisions. Morbid obesity is a medical condition, and only if you can be medically qualified will treatment for this condition be approved by insurance.

So the question really boils down to: What is your BMI?

valzie · August 4, 2007

Christinev- You are not alone here. We all have felt the way you do now. I have been approved by the insurance company and will be having the lapband on Aug. 13th.

In the packet I too listed the things you did I also included pre-diabetes, high cholestorol and triglycerides.

When everything was completed I also wrote a letter to the insurance company a personal letter explaining why I needed the lapband. I included personal and medical information. The insurance company only gets the medical info and does not get to know the person. Although I dont think it was the reason for my approval I think it did have an impact on it.

Valerie

christinev · August 4, 2007

My BMI is 42 or 43. The physical problems I have are things like my feet hurting especially my heals. My liver is enlarged, very fatty, high blood pressure, can't sleep because of the mound of fat on my stomach, depression. I can't stand to look at myself in the mirror. I make jokes about it to my friends and they laugh. I rather poke fun then others. Not that they ever would. I guess just as long as I have my sense of humor about it. I used to love going out dancing in clubs. Now forget it. I no longer fit into my "clubbing clothes" if you know what I mean. I would surprise people when they would play latin music and I would be out there dancing. I knew all the moves. I would feel so sexy. Now, I barely want to be intimate with my boyfriend. Has everyone had that problem?

Alexandra · August 5, 2007

Christine, if your BMI is above 40 you meet the medical criteria of morbid obesity, and therefore are medically qualified for bariatric surgery. Now, whether your specific insurance carrier will cover it is a whole 'nother question.

It sure sounds like you've reached that same physical and emotional point that brings so many of to surgery. I know EXACTLY how you feel, certainly felt that way myself, absolutely. In my case it wasn't "clubbing clothes" or intimacy with my boyfriend--it was being a safe parent for my children and knowing that my life and health were in danger if I didn't do something--but the pivot point is different for everyone.

Just know this: you are not alone.

ChloeH · August 6, 2007

Im not sure where you guys are all from but I'm from Australia and i got the lap band one week ago today. I only have a BMI of 33 but had no problems getting insurance approved. Is insurance stricter where you're from?

Alexandra · August 6, 2007

IIs insurance stricter where you're from?

Heh. This is the innocent question of the year.

Yep, Chloe, it's safe to say insurance is stricter in the United States, where most of us here are from. Depending on any of several factors it can be relatively easy to have medically necessary treatment covered, or almost impossible. Unfortunately, for "elective" things like bariatric surgery LOTS of elements have to fall into place.