What Are My Odds Of Getting This Done?

[kin7906 0]

I am 20 years old. My BMI Is 39.9.

I have no comorbities (sp?)

I have scheduled a consultation with the surgerion already i just wanted some advice before i meet with him.

i contacted my health insurance co. Highmark BCBC and they will do it with these requirements.

40 BMI

35 with 2 comorbities.

Proof of Failed Past Diet.

6 Mnth Nutrition Class

& Psych Evaluation.

$250 deductible they handle the rest.

so what do you think my chances are of getting it done (nervous) :thumbup:

[inuit 0]

Are you sure you have no comorbidities? Do you have sleep apnea? Arthritis? Back problems? Vascular restrictions?

[kin7906 0]

nope, only thing i have is osetoslaughters in my knee and asthma none but if i gain 2 more lbs my bmi will be at 40 so i wouldnt need any right?

[MiniBand 0]

Honestly we couldn't say what the odds are. Some people go through without any problems and others like me get denied. It's really hard to say. Also it is going to depend on what is in your company's plan, so even if someone had the same insurance plan it may differ. I have not seen a lot of posts about Highmark. I used to have them and for many things, my plan was covered more than the BCBS I have now. I chock that up to my employer though.

My best advice is think of every question about the surgery and the lapband that you have and write them down. *My* suggestions: Document everything and advise people on how to document your visits. Your PCP needs to be detailed in that you cover things like your weight, your behavior modifications, your exercise, your diet, etc. Those things need to be in every visit you make. You need to keep some kind of a journal yourself. I started using fitday. Get letters of support from people like trainers, therapists, every Dr. who has looked at you. Any written back up you can get helps.

I didn't realize how poorly my documentation was until I was denied, and now I am waiting for the appeal letter to go out any day from obesitylaw.com. We'll see what happens. Since you are starting out, read everything you can, write your questions down, start making behavior modifications, and journal.

Good luck. Also you can try and see what others have gone through with your insurance by typing in Highmark to the search box.

[kin7906 0]

thank you and good luck to you also i hope everything works out for ya. l

keep me posted.