Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 Weight watchers worked for my insurance company. SO did LA weight loss. I had to show 1 year of diet history. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 I had to go through a cardiac evaluation (which involved running on a treadmill) and TWO psychiatric evaluations. My insurance didn't require 6 months of supervised dieting. They did require my complete medical history though. I guess there was enough in there to convince them. There are many hoops to jump through to get this surgery. It's been said over and over that it's not a " magic wand " it's a tool. And you have to work hard to get this tool, because the insurance companies do not want to pay for someone to have surgery and then fail themselves. The hoops are a way of making sure you understand what you are getting into and making sure that you will be compliant with the rules that go along with your new tool. in Indiana Open RNY 2/25/04 265/178/135 5'5 " Age 28 -- didnt expect this! Hi everyone, just wanted to say yesterday was my consultation with the surgeon and I am appauled at what getting this surgery includes. Even the doctor was saying that the insurance laws are to discourage people and I think thats really sad. But a 6 month physician supervised diet plan?? I have weight watchers for the last 9 months, Lucielle debit from my account and weigh in's there! but that dont count! but oh well the way i look at it, I have to go for 3 months and then they schedule the surgery. with christmas right around the corner and my family coming to NY from California and Hawaii being the first time i have seen my 2 sis and mom and nieces and nephews since my father died 3 yrs ago, I am taking it lighter than if they werent coming, I figure time will fly! But March 05 sounds SO far away......seems like the waiting game is just a big waste of time and with my colesteral over 300 and blood pressure of 190/120- i dont have a stroke! I am currently on diavan and lipitor to get the #'s down but yesterday it was 170/110 and i have been on the diavan for 2 months. did everyone have to go thru this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 The insurance companies don't want to pay for this because of the cost and nothing else. Say you are in your 30's and morbidly obese and lets estimate the cost of the surgery at $40,000. Well the insurance company already has a clause excluding any kind of diets for weight so they won't be paying for your 6 months supervised diets and the odds are your might have a bit of high blood pressure and maybe even the beginning of diabetes, but the medical costs of those are not high at the moment and on average before those two conditions worsen you will be in another job with another insurance company who still won't pay for diets and is paying maintenance on your co morbities cause that is all they will do is pay maintenance and it takes a lot of office visits and mediciation to exceed the cost of the surgery. Now a few more years pass and you are disabled, maybe even have had a stroke or other issues and you move from the private insurance realm to medicare or medicaid, guess what, medicare pays for the surgery after one phone call from the doctor and while you now have long term disabilities you can get the surgery and you will still need it but you have a whole lot more side issues that could have been avoided if there were laws in place to force the private insurance companies to cover this surgery when you were only really just obese. The insurance companies have fought a lot of these issues and finally had to cover them. Since I have been working I have seen the government force insurance companies to cover pregnancy (they didn't used to, kind a like it was your fault you know), substance abuse and mental illness. Lets hope since obesity is now a disease the ball will begin to roll in favor of this surgery. anne because the insurance companies do not want to pay for someone to have > surgery and then fail themselves. The hoops are a way of making sure you > understand what you are getting into and making sure that you will be > compliant with the rules that go along with your new tool. > > in Indiana > Open RNY 2/25/04 > 265/178/135 > 5'5 " Age 28 > > d] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 no...my company, mvp was wonderful, but they all require a provable history of failed diet attempts... i hear ghi is the worst, tho...and in the state of florida, blue cross will no longer be paying for this surgery AT ALL...it's a crime, these companies pay for the treatment of drug and alcohol addiction, but not for this vital surgery... i really feel it's because the fat prejudice is the last socially acceptable prejudice... tee mydadsbuddy wrote: Hi everyone, just wanted to say yesterday was my consultation with the surgeon and I am appauled at what getting this surgery includes. Even the doctor was saying that the insurance laws are to discourage people and I think thats really sad. But a 6 month physician supervised diet plan?? I have weight watchers for the last 9 months, Lucielle debit from my account and weigh in's there! but that dont count! but oh well the way i look at it, I have to go for 3 months and then they schedule the surgery. with christmas right around the corner and my family coming to NY from California and Hawaii being the first time i have seen my 2 sis and mom and nieces and nephews since my father died 3 yrs ago, I am taking it lighter than if they werent coming, I figure time will fly! But March 05 sounds SO far away......seems like the waiting game is just a big waste of time and with my colesteral over 300 and blood pressure of 190/120- i dont have a stroke! I am currently on diavan and lipitor to get the #'s down but yesterday it was 170/110 and i have been on the diavan for 2 months. did everyone have to go thru this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 Hey Sweetie, I was probably lucky all the way around with my Insurance but I had in the past 3 yrs already documented weightloss with a doctor for a different Ins. Co. I know it seems strict but if we balk at what the Ins. is requiring now then they might just make it even harder. I like your outlook on having to wait and applaud you for it. Show's your much more mature and able to deal with delay's. Enjoy your family coming to visit and your upcoming surgery in 2005! The journey only is allow you more time to get educated and possibly loose some of your weight so when you do have your surgery it will be a breeze. Keep your chin up those upabove like your Daddy and God will see you through it all. I know mine was with me during my latest adventure to the loosing side. Big hugs, in AL. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 With all the tests my dr. wants and the number of people wanting this surgery it took me 10 months to get my surgery, started October 2003 and have surgery in August 2004. On the bright side it gives you time to think and research the procedure. It also shows the insurance company that you are serious about the procedure. Hope this helps Pat in RI > Hi everyone, just wanted to say yesterday was my consultation with > the surgeon and I am appauled at what getting this surgery includes. > Even the doctor was saying that the insurance laws are to discourage > people and I think thats really sad. But a 6 month physician > supervised diet plan?? I have weight watchers for the last 9 months, > Lucielle debit from my account and weigh in's there! but > that dont count! but oh well the way i look at it, I have to go for > 3 months and then they schedule the surgery. with christmas right > around the corner and my family coming to NY from California and > Hawaii being the first time i have seen my 2 sis and mom and nieces > and nephews since my father died 3 yrs ago, I am taking it lighter > than if they werent coming, I figure time will fly! But March 05 > sounds SO far away......seems like the waiting game is just a big > waste of time and with my colesteral over 300 and blood pressure of > 190/120- i dont have a stroke! I am currently on diavan and lipitor > to get the #'s down but yesterday it was 170/110 and i have been on > the diavan for 2 months. > > did everyone have to go thru this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 i understand what you mean. i had the same situation with my insurance company. i had did weight watcher for a year but they said that it did not count because it had to be physcian supervised diet for it to count. also that i had at least be seeing the dr once a month on this superised plan. i told them that if i went to the doctor every time i wanted to try a new diet then i would just as well move in there because that is where i will be all the time. but i guess it was for the best it does you time to think i also took that time to try to get in the habit of exercising. and also get my mind right. at times it may seem that the ins companies are taking us through a bunch of changes (and it may be true) but some times that could be for the best. it gives us more time to think and do more research on the procedure, i know that is what i did. i tried not to dwell on all the denial letters that i received ( i received 3 before i was approved) i just stayed focus and positive and i kept appealing. i started my process in march of 2003 and i was approved aug 29th 2003 and i had my surgery on oct 28 2003. so do not be discuraged time will fly by and it will be march before you know it. nora 10-28-03 292/193/165 > > Hi everyone, just wanted to say yesterday was my consultation with > > the surgeon and I am appauled at what getting this surgery > includes. > > Even the doctor was saying that the insurance laws are to > discourage > > people and I think thats really sad. But a 6 month physician > > supervised diet plan?? I have weight watchers for the last 9 > months, > > Lucielle debit from my account and weigh in's there! but > > that dont count! but oh well the way i look at it, I have to go > for > > 3 months and then they schedule the surgery. with christmas right > > around the corner and my family coming to NY from California and > > Hawaii being the first time i have seen my 2 sis and mom and > nieces > > and nephews since my father died 3 yrs ago, I am taking it lighter > > than if they werent coming, I figure time will fly! But March 05 > > sounds SO far away......seems like the waiting game is just a big > > waste of time and with my colesteral over 300 and blood pressure > of > > 190/120- i dont have a stroke! I am currently on diavan and > lipitor > > to get the #'s down but yesterday it was 170/110 and i have been > on > > the diavan for 2 months. > > > > did everyone have to go thru this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 and blood pressure of > 190/120- i dont have a stroke! I am currently on diavan and lipitor > to get the #'s down but yesterday it was 170/110 and i have been on > the diavan for 2 months. > > did everyone have to go thru this? ================= Sorry I am so talkative tonight. I must have abug up my butt, but I am appalled at the medical community's approach to many things. That BP has got to be taken care of, and yes you could stroke out! Make your doctor deal with your high BP, you cannot last until March this way! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 Nora I haven't had my surgery yet but I am currently in the process I have my phsych eval monday I'm a lil concerned cause I have been on every diet known to man BUT I didn't keep records when I was on diffrent diets I mean I felt no need to I never In a million yrs would have thought I would need this surgery so I never kept track I know on my physch eval paper it asked ? like what diet u were on wich I could answer then it asked exact dates,weight at begining and end ect ect.... I can't answer them ? and I'm worried this might affect me getting the surgery that I sooooo deptrely need Love Debbie -------------- Original message -------------- i understand what you mean. i had the same situation with my insurance company. i had did weight watcher for a year but they said that it did not count because it had to be physcian supervised diet for it to count. also that i had at least be seeing the dr once a month on this superised plan. i told them that if i went to the doctor every time i wanted to try a new diet then i would just as well move in there because that is where i will be all the time. but i guess it was for the best it does you time to think i also took that time to try to get in the habit of exercising. and also get my mind right. at times it may seem that the ins companies are taking us through a bunch of changes (and it may be true) but some times that could be for the best. it gives us more time to think and do more research on the procedure, i know that is what i did. i tried not to dwell on all the denial letters that i received ( i received 3 before i was approved) i just stayed focus and positive and i kept appealing. i started my process in march of 2003 and i was approved aug 29th 2003 and i had my surgery on oct 28 2003. so do not be discuraged time will fly by and it will be march before you know it. nora 10-28-03 292/193/165 > > Hi everyone, just wanted to say yesterday was my consultation with > > the surgeon and I am appauled at what getting this surgery > includes. > > Even the doctor was saying that the insurance laws are to > discourage > > people and I think thats really sad. But a 6 month physician > > supervised diet plan?? I have weight watchers for the last 9 > months, > > Lucielle debit from my account and weigh in's there! but > > that dont count! but oh well the way i look at it, I have to go > for > > 3 months and then they schedule the surgery. with christmas right > > around the corner and my family coming to NY from California and > > Hawaii being the first time i have seen my 2 sis and mom and > nieces > > and nephews since my father died 3 yrs ago, I am taking it lighter > > than if they werent coming, I figure time will fly! But March 05 > > sounds SO far away......seems like the waiting game is just a big > > waste of time and with my colesteral over 300 and blood pressure > of > > 190/120- i dont have a stroke! I am currently on diavan and > lipitor > > to get the #'s down but yesterday it was 170/110 and i have been > on > > the diavan for 2 months. > > > > did everyone have to go thru this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2004 Report Share Posted September 11, 2004 anne I'm hoping and praying that all goes well for me monday I have my phsyc eval I am very nervouse I depreately need this surgery I am 25 yrs old morbidly obese i HAVE HEART DIESEASE,sleep apnia,edema from being obese and I'm disabled as well. I have been on every diet known to man. I need the surgery I want it badly I feel it will change my life. I'm scared of the sugery part but I can't go on like this I'm soooooooooo uncomfortable Love Debbie -------------- Original message -------------- The insurance companies don't want to pay for this because of the cost and nothing else. Say you are in your 30's and morbidly obese and lets estimate the cost of the surgery at $40,000. Well the insurance company already has a clause excluding any kind of diets for weight so they won't be paying for your 6 months supervised diets and the odds are your might have a bit of high blood pressure and maybe even the beginning of diabetes, but the medical costs of those are not high at the moment and on average before those two conditions worsen you will be in another job with another insurance company who still won't pay for diets and is paying maintenance on your co morbities cause that is all they will do is pay maintenance and it takes a lot of office visits and mediciation to exceed the cost of the surgery. Now a few more years pass and you are disabled, maybe even have had a stroke or other issues and you move from the private insurance realm to medicare or medicaid, guess what, medicare pays for the surgery after one phone call from the doctor and while you now have long term disabilities you can get the surgery and you will still need it but you have a whole lot more side issues that could have been avoided if there were laws in place to force the private insurance companies to cover this surgery when you were only really just obese. The insurance companies have fought a lot of these issues and finally had to cover them. Since I have been working I have seen the government force insurance companies to cover pregnancy (they didn't used to, kind a like it was your fault you know), substance abuse and mental illness. Lets hope since obesity is now a disease the ball will begin to roll in favor of this surgery. anne because the insurance companies do not want to pay for someone to have > surgery and then fail themselves. The hoops are a way of making sure you > understand what you are getting into and making sure that you will be > compliant with the rules that go along with your new tool. > > in Indiana > Open RNY 2/25/04 > 265/178/135 > 5'5 " Age 28 > > d] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Believe it or not the least stressful for me was the surgery. I have an excellent surgeon (less than excellent bedside manner however) and I have had other surgeries that were harder to recover from. Work very closely with your surgeon and PCP and do exactly as they tell you even if it makes no sense at the moment. Work with your PCP to document weight fluctuation when you had office visits like you lost 30 pounds between visits and you were on the ... diet, another time it was 15 pounds and you were on Weight watchers etc. anne > anne > I'm hoping and praying that all goes well for me monday I have my phsyc eval I am very nervouse I depreately need this surgery I am 25 yrs old morbidly obese i HAVE HEART DIESEASE,sleep apnia,edema from being obese and I'm disabled as well. I have been on every diet known to man. I need the surgery I want it badly I feel it will change my life. I'm scared of the sugery part but I can't go on like this I'm soooooooooo uncomfortable > Love Debbie > > -------------- Original message -------------- > The insurance companies don't want to pay for this because of the cost > and nothing else. Say you are in your 30's and morbidly obese and > lets estimate the cost of the surgery at $40,000. Well the insurance > company already has a clause excluding any kind of diets for weight so > they won't be paying for your 6 months supervised diets and the odds > are your might have a bit of high blood pressure and maybe even the > beginning of diabetes, but the medical costs of those are not high at > the moment and on average before those two conditions worsen you will > be in another job with another insurance company who still won't pay > for diets and is paying maintenance on your co morbities cause that is > all they will do is pay maintenance and it takes a lot of office > visits and mediciation to exceed the cost of the surgery. > > Now a few more years pass and you are disabled, maybe even have had a > stroke or other issues and you move from the private insurance realm > to medicare or medicaid, guess what, medicare pays for the surgery > after one phone call from the doctor and while you now have long term > disabilities you can get the surgery and you will still need it but > you have a whole lot more side issues that could have been avoided if > there were laws in place to force the private insurance companies to > cover this surgery when you were only really just obese. > > The insurance companies have fought a lot of these issues and finally > had to cover them. Since I have been working I have seen the > government force insurance companies to cover pregnancy (they didn't > used to, kind a like it was your fault you know), substance abuse and > mental illness. Lets hope since obesity is now a disease the ball > will begin to roll in favor of this surgery. > > anne > > because the insurance companies do not want to pay for someone to have > > surgery and then fail themselves. The hoops are a way of making sure you > > understand what you are getting into and making sure that you will be > > compliant with the rules that go along with your new tool. > > > > in Indiana > > Open RNY 2/25/04 > > 265/178/135 > > 5'5 " Age 28 > > > > > d] > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Thanks to all who replied and tried to make sense of this, I wasnt going to post pictures until I had lost weight but I figured WHY WAIT- Hope everyone is enjoying the cooler temp's and the wonderful season of fall- ~V ps. I put my pic's under Mydadsbuddy-- (gofigure) > Hi everyone, just wanted to say yesterday was my consultation with > the surgeon and I am appauled at what getting this surgery includes. > Even the doctor was saying that the insurance laws are to discourage > people and I think thats really sad. But a 6 month physician > supervised diet plan?? I have weight watchers for the last 9 months, > Lucielle debit from my account and weigh in's there! but > that dont count! but oh well the way i look at it, I have to go for > 3 months and then they schedule the surgery. with christmas right > around the corner and my family coming to NY from California and > Hawaii being the first time i have seen my 2 sis and mom and nieces > and nephews since my father died 3 yrs ago, I am taking it lighter > than if they werent coming, I figure time will fly! But March 05 > sounds SO far away......seems like the waiting game is just a big > waste of time and with my colesteral over 300 and blood pressure of > 190/120- i dont have a stroke! I am currently on diavan and lipitor > to get the #'s down but yesterday it was 170/110 and i have been on > the diavan for 2 months. > > did everyone have to go thru this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 My wait time from the original contact with my surgeons office until surgery was 14 months I believe and looking back on it I am glad it took that long. At the time it was sheer torture though! I was able to learn so much and prepare myself for a very different future in that 14 months. Now that I am on the other side and I have lost 121 LBS in 10 months I can honestly say I think the wait made me appreciate all of this a lot more. Use the time to educate yourself and to prepare for your very bright future. Learn about good nutrition and how to eat afterwards for the best results and staying healthy. Most of all learn how to begin loving yourself and accepting yourself no matter your weight. My best to you! Colleen lap-rny 11/03/03 315/194 > > > Hi everyone, just wanted to say yesterday was my consultation with > > the surgeon and I am appauled at what getting this surgery > includes. > > Even the doctor was saying that the insurance laws are to > discourage > > people and I think thats really sad. But a 6 month physician > > supervised diet plan?? I have weight watchers for the last 9 > months, > > Lucielle debit from my account and weigh in's there! but > > that dont count! but oh well the way i look at it, I have to go > for > > 3 months and then they schedule the surgery. with christmas right > > around the corner and my family coming to NY from California and > > Hawaii being the first time i have seen my 2 sis and mom and > nieces > > and nephews since my father died 3 yrs ago, I am taking it lighter > > than if they werent coming, I figure time will fly! But March 05 > > sounds SO far away......seems like the waiting game is just a big > > waste of time and with my colesteral over 300 and blood pressure > of > > 190/120- i dont have a stroke! I am currently on diavan and > lipitor > > to get the #'s down but yesterday it was 170/110 and i have been > on > > the diavan for 2 months. > > > > did everyone have to go thru this? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 I had the choice of 6 months doctor supervised or a 3 month dietician/nutritionist program. I choose the 3 month program and was able to process a little quicker. But it is sad what most insurances are requiring now. Dora in Tennessee Open/Lap RNY 9/20/04 Vanderbilt Hospital Quote Link to comment Share on other sites More sharing options...
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