All for nothing?

[KimB7811 115]

Just starting my journey. Had my first apt on the first with my surgeon, having my endoscopy on the 22nd, my nutritionist apt the 9th. .l also have been on a dr supervised weight loss program for close to 2 years now which she is currently writing up a paper to submit stating why she feels I’m a good candidate as well. My paperwork is coming together... but however, I’m just really thinking this is going to all be for nothing because insurance will deny me. I think it states I have to be with a BMI of 35+ for at least a year and I think I was at a BMI of 34 around nov before it started to go up.... not sure if that’s where they might snag me if they ask for records first? I’m barely squeaking by with BMI even though I have severe hypertension and need a knee replacement. I have my insurance requirements printed out and I’m trying to make sure I line all my ducks in a row but I can’t shake this feeling they’ll snag me somewhere... anyone have an issue getting approved when they were on the lower BMI side?

[Greenstar 31]

i got denied 7 times, i had to prove it was medically necessary, it wasnt because it was below the bmi its because they dont want to pay. insurance sucks, dont worry though the doctor knows what to say

[KimB7811 115]

On 3/8/2019 at 11:10 PM, Greenstar said:

i got denied 7 times, i had to prove it was medically necessary, it wasnt because it was below the bmi its because they dont want to pay. insurance sucks, dont worry though the doctor knows what to say

That sucks you had to fight that hard but I’m glad you finally got approved! I’m hoping he does. He seemed confident but you never know until that approval!

[ProudGrammy 8,322]

On 3/8/2019 at 5:21 PM, KimB7811 said:

All for nothing?

@KimB7811

has insurance given the official ok?

crossing fingers

kathy

[KimB7811 115]

2 hours ago, proudgrammy said:

@KimB7811

has insurance given the official ok?

crossing fingers

kathy

Not yet! We haven’t submitted anything to the insurance yet. I am meeting with my surgeon next Friday, the 12th, so I’m hoping that’s the appointment I will get told everything is ready to go in for submission. This waiting period is agony! Thanks for thinking about me. This site is so helpful and supportive through this whole process. It’s definitely a great community of people all going through this!

[Frustr8 7,886]

And you can talk to us, even when you feel like hitting your head against something, even when they build walls of brick that you feel like you can't surmount. We're here, many of us have battled against the many tentacled beast that is for-profit insurance in the USA in 2019. And quite a few have managed to win!

[KimB7811 115]

11 hours ago, Frustr8 said:

And you can talk to us, even when you feel like hitting your head against something, even when they build walls of brick that you feel like you can't surmount. We're here, many of us have battled against the many tentacled beast that is for-profit insurance in the USA in 2019. And quite a few have managed to win!

Couldn’t have said it better myself!!! We need to put up one hell of a fight against those good ol’ Insurance companies we pay an arm and a leg for to use! Makes sense right? But I have a feeling everyone here going through this are pretty tough and aren’t going to take no for an answer! In the meantime, we can all rant hear 😄

[Paradokx 0]

Hi! Hows it going?

[KimB7811 115]

11 hours ago, Paradokx said:

Hi! Hows it going?

Hi Paradokx! I’m still waiting to hear from insurance! I was hoping to know if I was denied or approved before the holiday weekend but that wasn’t the case. I am on my first day of the liquid diet because I’m scheduled for surgery on the 25th. I hope I will know for sure my fate on Monday....it will also be a bummer if I had to do this pre-op liquid diet for nothing! And on Easter to boot! How are you doing?

[Paradokx 0]

2 hours ago, KimB7811 said:

Hi Paradokx! I’m still waiting to hear from insurance! I was hoping to know if I was denied or approved before the holiday weekend but that wasn’t the case. I am on my first day of the liquid diet because I’m scheduled for surgery on the 25th. I hope I will know for sure my fate on Monday....it will also be a bummer if I had to do this pre-op liquid diet for nothing! And on Easter to boot! How are you doing?

Aw! Im sure you will here soon! Im just starting my journey, pre op consultation on May 13, and a long ways of testing and dieting ahead! Hoping my insurance does not require it haha.

[KimB7811 115]

38 minutes ago, Paradokx said:

Aw! Im sure you will here soon! Im just starting my journey, pre op consultation on May 13, and a long ways of testing and dieting ahead! Hoping my insurance does not require it haha.

The journey will seem long but it will be so worth it in the end! Keep me posted on your pre op visit! Good luck!