mlbdl 86 Posted May 13, 2016 I received a call from the surgeon's office today, notifying me that I received insurance approval for the sleeve. I'm now scheduled for surgery on June 30! I bawled my eyes out as soon as I hung up the phone. I was worried that I wouldn't be approved because my PCP refused to use the term "medically necessary" and note my family history of severe diabetes (loss of limbs and life) on the recommendation letter. She said I'm just overweight (yeah, OK, 100+ lbs. over the top of the range for my height is just overweight) and I'm not "sick enough" because I'm only pre-diabetic means it's not medically necessary. After coming to her for the 4 months of weigh-ins, and talking about it at every visit, I thought she knew better. I was shaking all day and trying not to cry at work. I'm not usually so emotional but I guess I didn't realize how anxious I was about not getting that approval because of the PCP. Since that interaction with her, I've been so demoralized that I've been going up & down the same 2-3 lbs. I think I kind of gave up, expecting to be disapproved. I'm glad I was wrong. I had planned on doing self-pay this year. Then our 2016 benefits came out in Oct. 2015 and I saw the news that bariatric surgery would be covered in 2016. I switched PCPs in November to be close to where I now live. Went to info session in mid-December, and started the 4-month process in January. Now I can move on to worrying about the pre-surgery diet, the surgery, and post-surgery life! Oh, and I will be changing PCPs. Share this post Link to post Share on other sites
LaDivaDev 129 Posted May 13, 2016 This is wonderful news, and I'm so happy for you! You just keep at it, and in no time, you'll be moving toward your goals. All the best to you!!! Sent from my iPad using the BariatricPal App Share this post Link to post Share on other sites
Beck90 189 Posted May 13, 2016 Congratulations on your approval.. I know how you feel.. I was very nervous waiting on my approval because I'm bipolar II.. and a lot of us get turned down because we're all painted with the same brush. And I'm glad you decided to switch PCPs it doesn't sound like if she didn't understand that 100 pounds overweight and pre-diabetic with a family history was medically necessary that she's a good fit for you. Share this post Link to post Share on other sites
lrogoz 11 Posted May 13, 2016 I know how you feel. I had to do 6 months of dietitian visits and was sure I would be disqualified because I didn't lose any weight during that time. I got the call last Friday that I was approved. I was in the middle of Kohl's and just stood there. I was in shock. Then she wanted to schedule it as soon as next week, and that shocked me even more. Getting used to it now. On day 3 of 7 of a clear liquid diet. Surgery is May 18. Share this post Link to post Share on other sites
RobertD16 47 Posted May 14, 2016 I received a call from the surgeon's office today, notifying me that I received insurance approval for the sleeve. I'm now scheduled for surgery on June 30! I bawled my eyes out as soon as I hung up the phone. I was worried that I wouldn't be approved because my PCP refused to use the term "medically necessary" and note my family history of severe diabetes (loss of limbs and life) on the recommendation letter. She said I'm just overweight (yeah, OK, 100+ lbs. over the top of the range for my height is just overweight) and I'm not "sick enough" because I'm only pre-diabetic means it's not medically necessary. After coming to her for the 4 months of weigh-ins, and talking about it at every visit, I thought she knew better. I was shaking all day and trying not to cry at work. I'm not usually so emotional but I guess I didn't realize how anxious I was about not getting that approval because of the PCP. Since that interaction with her, I've been so demoralized that I've been going up & down the same 2-3 lbs. I think I kind of gave up, expecting to be disapproved. I'm glad I was wrong. I had planned on doing self-pay this year. Then our 2016 benefits came out in Oct. 2015 and I saw the news that bariatric surgery would be covered in 2016. I switched PCPs in November to be close to where I now live. Went to info session in mid-December, and started the 4-month process in January. Now I can move on to worrying about the pre-surgery diet, the surgery, and post-surgery life! Oh, and I will be changing PCPs. You're in FL who is your surgeon? Share this post Link to post Share on other sites
mlbdl 86 Posted May 14, 2016 Dr. Wizman in Margate is doing my surgery at Northwest. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
kmorri 1,689 Posted May 14, 2016 I"m in Florida too, but I'm in North Florida right outside of Jacksonville. My surgery is Monday in Jacksonville at St Vincent's hosp in Riverside. Dr. Uchal is my surgeon. Share this post Link to post Share on other sites
mlbdl 86 Posted May 14, 2016 Wonderful!! Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
mlbdl 86 Posted May 19, 2016 I"m in Florida too, but I'm in North Florida right outside of Jacksonville. My surgery is Monday in Jacksonville at St Vincent's hosp in Riverside. Dr. Uchal is my surgeon. How did your surgery go? Recovering well, I hope? Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
mlbdl 86 Posted May 19, 2016 I know how you feel. I had to do 6 months of dietitian visits and was sure I would be disqualified because I didn't lose any weight during that time. I got the call last Friday that I was approved. I was in the middle of Kohl's and just stood there. I was in shock. Then she wanted to schedule it as soon as next week, and that shocked me even more. Getting used to it now. On day 3 of 7 of a clear liquid diet. Surgery is May 18. I hope today went well for you! Sent from my iPhone using the BariatricPal App This is wonderful news, and I'm so happy for you! You just keep at it, and in no time, you'll be moving toward your goals. All the best to you!!! Sent from my iPad using the BariatricPal App Thanks! Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
mlbdl 86 Posted May 19, 2016 Congratulations on your approval.. I know how you feel.. I was very nervous waiting on my approval because I'm bipolar II.. and a lot of us get turned down because we're all painted with the same brush. And I'm glad you decided to switch PCPs it doesn't sound like if she didn't understand that 100 pounds overweight and pre-diabetic with a family history was medically necessary that she's a good fit for you. Thanks! Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
lrogoz 11 Posted May 19, 2016 I know how you feel. I had to do 6 months of dietitian visits and was sure I would be disqualified because I didn't lose any weight during that time. I got the call last Friday that I was approved. I was in the middle of Kohl's and just stood there. I was in shock. Then she wanted to schedule it as soon as next week, and that shocked me even more. Getting used to it now. On day 3 of 7 of a clear liquid diet. Surgery is May 18.I hope today went well for you! Sent from my iPhone using the BariatricPal App This is wonderful news, and I'm so happy for you! You just keep at it, and in no time, you'll be moving toward your goals. All the best to you!!! Sent from my iPad using the BariatricPal App Thanks! Sent from my iPhone using the BariatricPal App Thank you finally feeling human again. Walking really helps! Lisa ???? Share this post Link to post Share on other sites
Rebaslp 5 Posted May 19, 2016 I received a call from the surgeon's office today, notifying me that I received insurance approval for the sleeve. I'm now scheduled for surgery on June 30! I bawled my eyes out as soon as I hung up the phone. I was worried that I wouldn't be approved because my PCP refused to use the term "medically necessary" and note my family history of severe diabetes (loss of limbs and life) on the recommendation letter. She said I'm just overweight (yeah, OK, 100+ lbs. over the top of the range for my height is just overweight) and I'm not "sick enough" because I'm only pre-diabetic means it's not medically necessary. After coming to her for the 4 months of weigh-ins, and talking about it at every visit, I thought she knew better. I was shaking all day and trying not to cry at work. I'm not usually so emotional but I guess I didn't realize how anxious I was about not getting that approval because of the PCP. Since that interaction with her, I've been so demoralized that I've been going up & down the same 2-3 lbs. I think I kind of gave up, expecting to be disapproved. I'm glad I was wrong. I had planned on doing self-pay this year. Then our 2016 benefits came out in Oct. 2015 and I saw the news that bariatric surgery would be covered in 2016. I switched PCPs in November to be close to where I now live. Went to info session in mid-December, and started the 4-month process in January. Now I can move on to worrying about the pre-surgery diet, the surgery, and post-surgery life! Oh, and I will be changing PCPs. Share this post Link to post Share on other sites