New Independent Health criteria

[nessa259 19]

So, just scheduled my first apt. with the surgeon for October 28th only to find out that my insurance just changed their criteria. :frown: The rep at the surgeon sounded extremely flustered as she told me, and they don't even know what the criteria is. She scheduled the consult anyway to see if I am even a candidate. Now, let's go back to mid-August when I started all of this. Talked it over with my Dr. and she is ALL for it, has had patients that have really benefited from it. So, I get the packet from insurance, get the packet from surgeon, submit the info to the surgeon, get the ok for the psych. exam, go for the psych exam, get the referral from Dr. all paperwork in on my part and then I find this out. Seroiusly? So I call insurance last week after I get off the phone from scheduling my consult. Even their Rep doesn't know of any changes. I call again today, apparenlty I have to be on triple treatment for hypertension (or diabetes) and I have to loose 10% (actually 26%) of my body weight in the past and keep it off for 6-12 months before my surgery. Now, let's think about this. I have lost 10% of my body weight, kept it off for 6 months, only to gain it back and more afterwards. Do you think that I would be doing this if I COULD KEEP IT OFF???? Seriously? And apparently I am ineligible because I only take TWO meds for my hypertension? I am SO frustrated. I just feel like I am going to be this way forever. I understand that you need to make sure people know that this is a lifestyle change, not the easy way out. HOWEVER, since I have struggled with my weight since, oh I don't know, they age of SIX, you would think I need a little more help than skipping a few meals? You don't think that I have tried and failed so many times that maybe I need some fliping help? What the heck do I pay into insurance for anyway? I feel defeted. I don't really know where else to go. They are sending me the criteria in the mail. I guess I will take this to my Dr. and go from there. So hopefuly I will be banded in the next decade. Anyone else have problems like this??? :biggrin:

[plain 12]

So, just scheduled my first apt. with the surgeon for October 28th only to find out that my insurance just changed their criteria. :frown: The rep at the surgeon sounded extremely flustered as she told me, and they don't even know what the criteria is. She scheduled the consult anyway to see if I am even a candidate. Now, let's go back to mid-August when I started all of this. Talked it over with my Dr. and she is ALL for it, has had patients that have really benefited from it. So, I get the packet from insurance, get the packet from surgeon, submit the info to the surgeon, get the ok for the psych. exam, go for the psych exam, get the referral from Dr. all paperwork in on my part and then I find this out. Seroiusly? So I call insurance last week after I get off the phone from scheduling my consult. Even their Rep doesn't know of any changes. I call again today, apparenlty I have to be on triple treatment for hypertension (or diabetes) and I have to loose 10% (actually 26%) of my body weight in the past and keep it off for 6-12 months before my surgery. Now, let's think about this. I have lost 10% of my body weight, kept it off for 6 months, only to gain it back and more afterwards. Do you think that I would be doing this if I COULD KEEP IT OFF???? Seriously? And apparently I am ineligible because I only take TWO meds for my hypertension? I am SO frustrated. I just feel like I am going to be this way forever. I understand that you need to make sure people know that this is a lifestyle change, not the easy way out. HOWEVER, since I have struggled with my weight since, oh I don't know, they age of SIX, you would think I need a little more help than skipping a few meals? You don't think that I have tried and failed so many times that maybe I need some fliping help? What the heck do I pay into insurance for anyway? I feel defeted. I don't really know where else to go. They are sending me the criteria in the mail. I guess I will take this to my Dr. and go from there. So hopefuly I will be banded in the next decade. Anyone else have problems like this??? :biggrin:

nessa, that really sucks! Is there any way your general practice doc will "work" with you on your medications? And will a letter from your doc and the surgeon to the insurance company help? For some insurances, letters from the doc can affect a decision. Good luck!