Insurance-how did you deal with waiting for a decision?!

[kimmi5207 0]

How you do make it thru the wait, while you are waiting to hear whether or not your insurance approved or denied the surgery? The "not knowing" is horrible. And the more I read various posts, the more scared I get that I am getting my hopes up for nothing. :phanvan

The anxiety is driving me crazy....I don't want to be optimistic, and then be disappointed. But at the same time, I'm doing all this research and talking with people who have had WL surgery to see how they liked it, etc. I've even gotten the support of my mom and dad (and I thought my dad would be completely against the lap band-he shocked me with his support). And I've tried so many diets, and lost 40 or 50 lbs, but I always gain it back with additional weight. I can't seem to do this long term on my own, so I really need insurance to cover part of it (because I can't pay $13K for surgery).

The office said I should know in 1 to 2 weeks (it's been 1 week), but from what I've seen on here, United Healthcare can take forever sometimes, and then deny you. And of couse, right now we have the Thanksgiving holidays, so nobody is going to be looking at it then. The doctors office actually asked if I wanted to schedule surgery for November 30th, so they seemed pretty confident of a quick approval from United Healthcare, but I can't take off the beginning of the month, so if I'm approved, I'm going to have it during my Christmas vacation time.

I've heard that some people call their insurance company to check the status of their request, but I'm scared that if I call the insurance company directly, I may mess something up and cause myself to be denied.

Just wondering how others made it thru this. If you did call to check on the status of your request for preapproval, exactly what did you ask when you called in?

Thanks!

[TerriDoodle 6]

I was self-pay, but I just want to say that after my time on this board and watching others' ups and downs with insurance woes, I'd just like to suggest that you prepare yourself for the possibility of denial...AND be prepared to appeal. It seems to be a game that the insurance companies play so that they can hold on to as much of their money as possible. It's like they HOPE you'll just give up and walk away....BUT DON'T!! I've seen some that had to appeal as many as 4 times before they got approved. So be mentally ready for that....and to fight to the bitter end. There are even agencies that will help you, and get good results, if you need their help. I just Googled "lawyer obesity surgery appeals" and found this one real quick: Obesity Law and Advocacy Center -- there are others.

Best of luck to you!!!

[destiny79 0]

UHC Texas just APPROVED me in 10 days the customer service said that at the end of the year they have 15 days to approve are deny cause of the time frame. the only requirement I had with UHC is that my BMI was 40 I called them every siingle day and started a thread here waiting to be approve and I vented there it help

[kimmi5207 0]

Wow! Thanks to both of you for the advice. After all I've heard, I should prepare myself for the initial denial, and I know I will appeal (because they try and not pay and many give up after being denied). It's just that normally I'm a negative person (i.e. expecting the worse) but for some reason I've been feeling really positive about this and it took me a while to accept that I can't do this on my own. I just hate to go thru the whole appeal process but I will if needed!

I have United Healthcare Choice plus (I live in Texas). I wonder if the same deadlines apply to me since it's the end of the year? I may just try giving them a call. Thanks

If anyone else has any other advice & experiences, I would love to hear it!

Thanks again.

[destiny79 0]

:whoo:I think you will be approved really soon for some reason UHC choice plus Texas is the easiest to get approved I think they said texas is fat lol but that's good for us. (I am sending approval vibes to you ):whoo:

[Just_A_Girl 0]

Kimmi, It sounds like we have a lot in common. I am 30 years old and live in Texas too. I will submitt all of my information to the insurance company on Monday. I have BCBS with the school system. I am so nervous about getting denied. I am afraid I will be depressed if I do. I am also hoping to have my surgery over Christmas Break since I will already be off of work. I know that the BCBS I have will pay for it because I have heard of a few other employees that have had the lap band. I have to submit 6 months of visits and documented weight loss attempt and medical records proving that I have been overweight for the last five years. I have tried my best to get everything they needed and now I am just hoping it will work. I can understand why you want to call the insurance company to see if they have made a decision or not. I think I would be the same way. I see what you are saying about calling and possibly messing something up. I know it is hard to resist that temptation!! I would like to keep in touch if you want to ... it sounds like we are in the same boat! I wish you all the best.

[Fae 0]

I'm actually in the same boat you are in. I have not applied, but I have been told I have a good chance. So I have been researching like crazy, trying to gather up enough papers for my co-morbidities and the length of time I have been obese. I'm scared to death of getting denied, since I know how picky insurance companies can be. I have no money for something so expensive, so this is my only chance as well. I'm wishing you luck. Fae

[Just_A_Girl 0]

Where are you from? What insurance do you have? Did you have to do 6 months of weight loss doctor visits or gather 5 years of medical records? Do you chat on yahoo??

[lonestar5212 0]

This whole process is so stressful. I have been stressed out since I first went to a seminar! Worry, worry worry about getting approved. It shouldn't be this hard. I have felt like I am on a rollercoaster for sure. Pure excitement, then down when I read about all the difficulities people have had with insurance. Trying to gather everything I need for health history, checking, double checking, making the appointments, then getting excited again and then down again, etc. I think I am going to drive myself crazy. And I haven't even submitted to insurance yet!! I think that will be VERY difficult waiting. So, I am saying, you are totally normal for feeling the way you do. I think we must all go through the same process. I am crossing my fingers that you get good news soon!!! Good luck and keep us posted.

[Fae 0]

If your referring to me, I have medicare. I'm going for the six month wait period with the diet, so I know that is ahead already. I also have stuff as early as 2002 saying I was obese. I've been overweight since childhood. I have a couple co-morbidities, but it takes time to gather paperwork and such. If you want to chat, I have aim. I have yahoo too...but I never use it ^^;; Fae

[Just_A_Girl 0]

Sorry Fae, I guess I could have addressed you in my reply!! sometimes my fingers type faster than my brain works ... especially when I am thinking about getting my lap band!! I think this is seriously driving me crazy. It seems like all I can think about these days. How much longer do you have to do you have on your six months??

Lonestar, I know what you are saying ... thinking of the lap band seems to have taken over my mind ... I am thinking about what it would be like to have it and how much better I will feel once I do all day long. It is kind of weird that you mentioned the up and down feelings ... I have been doing the same thing for the last six months. I hope to submit mine this coming Monday ... When do you plan on submitting yours??

[destiny79 0]

I just got my approval letter in the mail it really real now seeing everything in black and white (still sending approval vibes to everyone let me know as soon as you get approved )

[Jenn1969 0]

Does anyone know how Kentucky BCBS covers? I have contacted the surgery center insurance specialist. She is checking into it for me now. My doctor went over my records and I have both the 6 months of weight loss Dr. visits (well over that) and about 19 years of being overweight with dr. records.

[Fae 0]

My first doctor's appointment is in the beginning of December, so that is when I'll be starting. I know, I have a long way to go ^^;; Fae

[destiny79 0]

while u might as well start now rather than later the time will pass by fast for you , they have you so busy with Dr. appointment Labwork and weight history.