Got my insurance requirements....help? xposted

breezy25
on 12/3/15 1:51 pm

Oh you said "This is me made over" so I thought there was a pic lol.

 

That is exactly my sadness! ANOTHER FAT SUMMER!

Starlene02
on 12/3/15 2:03 pm
VSG on 11/11/15

OH! haha.. I was referring to the way you're feeling and the things you're experiencing and even the choices you're making. Although from our profile pictures we do seem to have a similar face shape! lol

Sorry if that didn't make sense. I just had my first check up yesterday and it was a 3 hour drive  both ways so I'm still a bit wiped out. I got some brain fog going on! I've been on liquids for over 3 weeks and my doctor says I can start slowly incorporating soft foods into my diet so that next week I'll officially be on soft foods! I've seen enough soup for a while! At the moment I'm munching on 1/4 of a Wendy's baked potato! YUM! It seems to be agreeing with me so far as long as I eat it slowly. Time will tell I guess.

If you feel like quitting, think of why you started.



 

breezy25
on 12/3/15 2:24 pm

It makes sense now! Haha. My SIL had her surgery a few days ago and is still really sore.

i wish I didn't have 7 months to wait. I'm also scared I'll get stuck with bypass because my ins is saying VSG is experimental. But I am wondering if I can contest that somehow.

Starlene02
on 12/3/15 10:27 pm
VSG on 11/11/15

VSG is proven to have less nutritional deficiencies so I would at least try. I mean why would they deny you a surgery where they are less likely to have to pay out of their own pockets for any issues that may arise? With insurances though you never really know.

I wish you didn't have to wait that 7 months either. I also wish this weight would just all melt off and it wasn't so dang hard to wait for it to fall off .2 pounds at a time!! I want it NOW! Not a year from now! It will be a difficult wait but I suppose it'll at least prepare you for having patience with your weight loss!

I have a friend that has been sending me encouraging little meme's every few days cause she knows how hard it can be to fight the discouragement. We all need a few friends like that for sure!

If you feel like quitting, think of why you started.



 

mictariam7
on 12/4/15 3:14 am

Hi Breezy25,

I also went to a Bariatric Center of Excellence here in Bowling Green, Ohio.  I'm not sure if that's the one your going to but if it is they have all of this worked out and can tell you exactly what you need to do and will work with your PCP to get the records and information needed.  They have been amazing at handling everything and have the nutritionist right there on site that you will visit every month to guide you through the program and teach you about the requirements for the type of surgery your doing.  I'm sure if it's a different center they will be very knowledgeable just like the one here and will ease a lot of your anxieties and help get you through all the paperwork. 

It does take some work and time but it is so worth it.  I can't wait to get into a bathing suit and do something with my daughter just like you.  I know how hard that is but just keep your eye on that prize that once this is behind you it will be life changing and you will be able to do more with your kids. 

I wish you the best of luck on your journey.  Don't get discouraged.  It takes time and work but it is well worth it in the end.

 

M

breezy25
on 12/4/15 7:59 am

Aww that message made me tear up!! Thank you for the encouragement and support. It really, really helps :)

mictariam7
on 12/4/15 3:17 pm

Your so welcome breezy.  The surgeon's office will look into the comorbidities needed for your insurance.  Sleep apnea is definitely a qualifier and don't forget your BMI is too.  Don't worry they will take care of everything.  :)

cappy11448
on 12/2/15 6:14 am

I'd suggest checking with the NP at the surgeons office to clarify what is needed to prove the medically supervised diet.  I had a requirement for a 3 month medically supervised diet and I lost 50 pounds - not failing, but I think the previous 40 years and a starting weight over 350 pounds was proof enough that I had a history of failures. 

It was never clear to me why they required the pre-surgery diet, but my success was applauded and not a problem.  So check with your surgeons office.  they do this all the time.  They'll have the answer.

best wishes on your weight loss journey.

Carol

    

Surgery May 1, 2013. Starting Weight 385,  Surgery Weight 333,  Current Weight 160.  At GOAL!

Weight loss Pre-op 1-20 2-17 3-15 Post-op 1-20 2-18 3-15 4-14 5-16 6-11 7-12  8-8

                  9-11 10-7 11-7 12-7 13-8 14-6 15-3 16-7 17-3  18-3

     

breezy25
on 12/2/15 5:47 pm

Hi Carol - what's an NP?

White Dove
on 12/2/15 7:16 am - Warren, OH

My BMI was just at 40 and my nutritionist advised me not to go under 40 BMI on the supervised diet.  That is just my experience, but an insurance company can deny you if you don't meet the requirements.  Some companies may go by your starting weight, but there is no guarantee.  I stayed at 40 BMI until after my insurance approval.

Real life begins where your comfort zone ends

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