Denied
 

I wanted to let you guys know that my request for lap band surgery has been denied.

For those of you who don't know, I applied for lap-band surgery 12 months ago. I was told that I needed to have 6 months of doctors supervised weight loss visits. So I went for 6 months and in September applied again only to be told that "ooops" you need 12 months of visits. So I went for 6 more months. I finally turned everything in again, only to be denied.

Their policy is pretty clear “Charges for weight control or Obesity, including diet control, diet supplements and physician approved weight loss clinics are not covered except for the medical treatment of Obesity which is a direct and immediate threat to life.”

My medical problems are high cholesterol and I have slightly elevated blood pressure. Nothing life threatening.

I knew this was their policy before, but I assumed that due to my high BMI and my the medical problems that I do have that I would be approved. No such luck.

I found out 2 weeks ago, so I am fine with it now. I have decided not to appeal. The whole process has wore me out. I have been doing pretty good since I found out I was denied and plan to continue.

Thanks for all your support during this crazy process.

you've already lost weight on your own. don't give up, we are here for you. one day at a time ;)

Sandi - I'm sorry that this didn't work out for you after your hard work. :hug: You can continue. You can do this. We are all here for you.

:hug: I'm sorry, Sandi. Sometimes insurance companies make me cranky. Hang in there, girl! You own the power to make your future how you want it to be. WLS is a tool, a great one, but NOT the only one. Peace and strength to you, my friend.

I'm sorry they denied you but it seems like you have the right mind set about it!

I'm sorry hon! ...that really sucks...but think about all the things you've learned. You've learned some nutrition stuff, I'm sure. You can do it! Take it slowly and you'll do great. I'm confident!

:hug: to you my friend. I'm really sorry :cry:

i am sorry to hear about your stupid ins co. when will they realize that this saves them money in the end from heart problems. dm and the likes. i wish you luck on your journey and i want to tell you that you can do it!!

Woot To You!!!
 

I'm so sorry that you have been denied, but you are on a good course now. So...stick with it. We'll all be here to help you. My hat is off to you for the positive attitude that you have as well as my prayers.

what in heaven's name are those insurance people THINKING???????? there's a big difference between surgery and 'diet control, diet supplements and physician approved weight loss clinics.'

your decision not to appeal is a reasonable one - and now i'm going to give you the BEST ADVICE I HAVE. [not sure it's actually WORTH anything - but here goes!]: once you've lost a chunk of weight [like you just have!], focus on MAINTAINING that loss for a few months. and then lose another chunk. i know you've had issues with losing/regaining/losing/regaining. this is one strategy that i've read a lot about that seems to work for a lot of people.

no matter what you decide, we're here for ya!

Jiffy,

I think you are right on. Really that is what I've had to do. I've lost, maintained, lost, maintained, etc. In 2 months, it will be my 4 year anniversary. Some people can loose all in one single 'effort' but I think going from where I was and how long I had been obese, it was hard mentally for me to do that.

Anyway Sandi, as always, we are here for you :)

:?:I'm sorry you were denied.:hug:

I'm so sorry you were denied!
I was denied initially, too...but then I appealed and it went through! I understand not wanting to go through the appeals process though.

Where do you live in Northwest Indiana? I'm in Valpo :)