Turned Down! :(

[CATHY1102 0]

I have been awaiting approval from BCBS Illinois, for about 5 weeks. I found out today that I was turned down, because I do not have a documented full year of going to a physician for weight loss. I am so disappointed. I was on Phen-Phen yrs ago for about 6 months, was told that was too old....I have been on every diet since that time, that anyone can imagine..including hypnosis! I am sure many of you can relate. I have only just recently ( 2 months) been diagnosed with hypertension. I have had a hip replacement, and was told I may need another one and also a knee replacement...needless to say it is hard to excercise with 100 lbs of extra weight. Anyways, I felt like I need to write and get this off my chest...DOES any knowlegeable person have any advice for me? Thanks for your time.

Cathy

newport news va

[piercedqt78 658]

Was the hypnosis done by a doctor? That should count as medically supervised weightloss if it was, what about the other diets? Did you see a doctor? I would also ask what they consider medically supervised. How long ago are they willing to consider 3 years, 5 years? Do the 12 months have to be consecutive? Or can they be accumulative (sp?)? I know that I could go back 2 years, and had to find 6 months of combined medically supervised weightloss. Does it have to be a nutritionist or doctor? Can it be monthly nurse weigh ins and BP checks? These are the things you need to find out. My doctor gave me a low cholestrol low fat diet and exercise plan out of a book. I then checked in with the nurse once a month to be weighed and have my blood pressure checked. That counted. Best of luck, I know it is possible to fight and win, I did. ~Mandy

[bbblampwork 0]

Cathy,

I am so sorry to hear that. I hope that maybe you can find some way around this. I am afraid of the same thing happening to me. I have been overweight since I was a teen. But nothing about seening a Dr. consecutivly for 1 yr. Good luck girl I hoping that maybe you can find away around this. Please let us know.

Wishing you well,

Beth

[Jachut 487]

Yeah well DH's GP told him it was easy to lose weight - he said if you work at a desk all day there's no need for lunch! I dont know anything about the medical profession over there but the standard of GP care over here can sometimes be pretty appalling. Bulk billing has killed the trusted family doctor that's for sure.

But I've read the same thing, I dont think it tends to be true here, our private health insurance covers everything bar cosmetic procedures, but I said to myself if that's what they wanted I would see a dietician and make every effort and try to get the most out of it that I could - and that in a year's time I could well be at goal weight.

Not likely probably but possible.

[fee 0]

Hey Cathy....sorry to hear

Whats with these insurance companies wanting a full one year of going to a dietitian. Do they actually want to pay for the visits?

Like Mandy said fight and win like she did. You can do it. If you have to have weekly weigh ins thats a bit to extreme. Find out more info!!

Good Luck

[Teresita 0]

Cathy I see you are in VA my doctor is in Fairfax VA and he is excellent. I met 2 of his clients who drive 3 hours for their appoinments and surgery. They know how to do the paperwork for the insurance companies. I have BCBS/Blue Choice. http://www.inova.org/inovapublic.srt/ifoh/index.jsp

Good Luck, they are awesome!!!

[CATHY1102 0]

tHANK YOU ALL SO MUCH FOR YOUR SUPPORT. I AM DEFINITELY CHECK IN TO SOME OF THESE THINGS. YOU ARE RIGHT MANDY, I DIDN'T THINK THAT MAYBE THERE MAYBE A "LOOP HOLE" I CAN USE LIKE COMBINING WEIGHT LOSS VISITS TOGETHER TO EQUAL 12 MONTHS. I AM GOING TO HAVE TO READ THERE CRITERIA CLOSELY. I HAVE ALSO THOUGHT TO TRY TO FIND OUT WHAT INSURANCES WILL NOT HASSLE YOU AS MUCH, AND SWITCH..I DO NOT KNOW IF THAT CAN BE DONE, BUT I AM NOT GOING TO GIVE UP, THATS FOR SURE. IF LATER IN MY JOURNEY THRU THIS, MY EXPERIENCES CAN HELP SOMEONE ELSE, THAT IS GOOD TOO. I AM ALSO GOING TO CHECK OUT THE DR IN FAIRFAX, BECAUSE LIKE TERESA SAYS, SOMETIMES THE PAPERWORK THEY SEND CAN MAKE A DIFFERENCE. THANKS TO ALL. I WILL KEEP THIS SITE POSTED.

CATHY

[Teresita 0]

Good Luck Cathy!!

[cissy 0]

Cathy- since you would consider changing insurance companies, United Health Care covers weight loss surgery where there is a diagnosis of MO (with my plan, the diagnosis came in the consultation appt with the surgeon). It only took them 10 days to approve me, and my surgery is in two weeks (Sept 14).

I really hope everything works out for you! I understand how it feels to be 100 lbs overweight, because I am too.

[I'llsucceed 1]

so sorry- The same happened to me as far as not having an entire year of consistant weight loss managed by my Doctor. I think it sucks! Especially when I have 15 years of it just not all 12 months in a row! I hope so miracle happens for you!

[CATHY1102 0]

Thank You So Much For Your Well Wishes, Teresa And Christina! I Wish You All The Best Too! I Wish I Had The Money To Self Pay. Thanks Christi; I Definitely Will Try To Find Out About United Health Care. Good Luck With Your Surgery!! Keep Me Posted.

Cathy