At The End of My Rope

[tizzylish 0]

Good Morning Everyone. I am looking for someone, anyone who can help me. I am 34 years old and have been fighting with my weight for the last 16 years. I have as I am sure most of us have tried every diet, fad, pill and potion out there to lose weight. I am to the point that I am not living, I am hiding. I feel like no one including myself sees me anymore that they only see the fat person I have become. It has gotten to the point that I am not the only one suffering anymore, but my children are too. They want to go to the Water and amusement parks, and I just won't go. Because I am mortified at the thought of putting on a swimming suit and the thought of not being able to fit on a ride is enough to make me want to go to bed for the rest of my life. But also my back and joints can’t take it anymore.

Yesterday I went to my doctor to finally discuss what my options could be, including counseling a nutritionist and bariatric surgery. Because I am having health problems due to my weight, and the fact that there are other problems that are sneaking up on me but have not reared their ugly head as of yet. She thought that I was an excellent candidate for the lap band surgery. She asked me to call my insurance company and find out what doctors they would work with. I left her office feeling happy and unbelievably hopeful for the first time in I can't tell you how long.

I called my insurance company immediately only to be told that they would not cover this for me. I don’t understand. Why would they want to cover insulin and heart medication, back and knee surgery but they do not want to cover something that could help avoid all of it. I feel absolutely defeated. If someone has any suggestions, advice anything please let me know. Thank you all in advance.

[vballmom 0]

Tizzylish, If your insurance company will not cover the surgery, I have heard of people getting loans to cover the expenses. I know that getting the surgery in Mexico can be less expenisive. Find a surgeon and talk to his staff about your insurance they are usually skilled in how to get you approved if you insurance company has any loop holes.

As for going to the Water park with the kids, go to a location out of town, where you wont run into anyone you know. Get a long tee shirt to cover up and just say screw the world and do it for your KIDS!. I understand how you feel because Ive hidden out from the world also. I was fortunate that my insurance company did cover the surgery because I had lots of co-morbilities. Maybe give Weight Watchers a try while you work out trying to get lap-band surgery. Please dont let the idiots in the world stop you from doing things with your kids. I am sorry you are going through this and you are not alone. I did have my surgery after jumping through a lot of hoops and doctor visits. I still have weight to lose, but I am facing the world head on now. Best Wishes.

[juliansmom2003 3]

Tizzylish, did the insurance company give you a reason that they wouldn't cover it? Is it that they just don't cover WLS or would it make a difference if your doctor wrote a letter of medical necessity and a surgeon was able to confirm that you are a perfect candidate for this? Perhaps they have other weight loss/healthy lifestyle programs you can try before taking this step? I did a search online and here is a great reference resource I found. Maybe it will help you: http://www.lapband.us/lap-band-insurance.html

ITA with the previous poster. Go somewhere that you know no one, put on the suit and a t-shirt. Your kids won't care one bit and they are more important than any idiots out there that make you feel ashamed.

((HUGS)) Don't give up. This is a great forum and honestly, surrounding yourself with positive people and getting support like this while considering taking this step is major. DON'T GIVE UP! There is always a way.....

Edited June 2, 2009 by juliansmom2003
Adding a resource website

[tizzylish 0]

Thank you for your responses.

My insurance company told me that they do not cover WLS, and when I asked her why she said that it is not the insurance companies fault that I have a weight problem.

I currently do weight watchers and do my best to get at least 20-30 minutes of exercise daily. This is not easy since it is really hard on my knees and back.

Can someone please tell me what co-morbidities they had and if that made it possible for your insurance to approve you. As of right now, I have as I mentioned back and knee problems, I am pre-diabetic, urinary incontinence and sleep apnea. The only thing that is in decent shape is my blood pressure, thank God.

Is it possible to fight my insurance company on this decision?

I think what really bothered me the most yesterday is that my doctor told me that many insurance companies are approving this surgery more readily now and that even Medical Assistance covers it. I pay over $1000.00 a month for my families insurance and they will not help me. That hurts.

[lotsabirds 0]

tizzzylish, email me privately. I have a thought on this that might help. lotsabirdsaz@msn.com

[Cabickley 0]

a lot of doctors offer no interest payment plans too.

what insurance company do u have?

dont give up!

[vballmom 0]

tizzylish My co-morbidities were, high blood pressure, diabetes, sleep apnea, hypo-thyroid, bad back & knees. I have lost 82 pounds, I now take less medication. Exericse for the bad knees & back try Water aerobics. I know you don't want to be in a swim suit in public but it does burn a lot of calories and is easy on the knees and back. There used to be a thread on this site that list the insurance companies and stories of people & the problems and successes of getting approved. Hang in there.

[BethFromVA 5]

My insurance company told me that they do not cover WLS, and when I asked her why she said that it is not the insurance companies fault that I have a weight problem.

Wow... what a biotch! :frown:

[tizzylish 0]

We have kind of a strange insurance. It is called WI Masons, it is a Union insurance. We pay out the nose for it, but I guess that is pretty normal these days.

[TopTier 0]

Yikes! That person needs to get another job where she/he doesn't interact with human beings!

[OnTheWay to Thin 0]

Tizzy unfortunately, if your insurance program specifically excludes wls there is nothing you can do to get it covered. Many more programs are covering surgery but your employer has to purchase the benefit for it to be covered. It is unfortunate that medical necessity does not pre empt this just yet, but that is the way it is. I just had my surgery last week and am blessed that my insurance did cover it, but I know had it not I would have found a way to do it. My knees are bad and I have to lose this weight or I will eventually not be able to walk so that was a pretty big motivator for me. Good luck and let us know if we can help in any way.

[CarmenPonce 0]

I am a Health Insurance Broker and also a fellow banster. Feel free to message me and i can help you to navigate the insurance nighmare.

[FailureIsntAnOption 0]

Will your insurance cover gastric bypass? Some will even though they don't cover lap band. If you are certain that the lap band is what you want to do then email me and I will tell you what I did when my insurance wouldn't cover lap band. donna2153@aol.com

[TopTier 0]

By the way, I had uterine cancer when I was in my 20s. I'm soooo glad my insurance company didn't feel they were not responsible for my treatment, given they didn't cause my cancer, either!

[tizzylish 0]

I am so sorry to hear that you had cancer. I hope everything is ok now. I think that some people who have been fortunate enought to never have had a weight problem think that they are justified to point out to those of us who do that we are overweight. Like we do not know that every second of every day of our lives. I just try to tell myself that God does not like ugly and though I may be fat on the outside I am beautiful on the inside. And all I can say is Karma is a biotch!!!