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Disappointed, disheartened and darned mad!!!!!!

tracy L.
on 4/9/12 2:44 pm - PA
RNY on 05/21/12 with
Well, appointments today with dietician and fitness were a bust, of sorts. Thought insurance submission would be getting underway this week but no such luck BCBS/NEPA has decided that their hard working, money paying insured folks who need wls, have to wait six months, medically supervised diet before you can be considered. There is apparently going to be a board meeting in early May, to review their policies on wls. One can only pray that they will catch up with the rest of the modern world. I am sooooo completely disappointed and sad, BUT, I will NOT NOT NOT give up this pursuit, which I am sure the insurance company wants!!!! Grrrrrr:-0
        
(deactivated member)
on 4/9/12 2:46 pm - TX
 My BCBS didn't cover it at all.  I'm having to pay for the whole thing.  Be glad you have WSL coverage, even if it will take a little longer!
tracy L.
on 4/9/12 2:58 pm - PA
RNY on 05/21/12 with
Hi red! I am very sorry to hear that your BCBS doesn't cover wls. I would not have the money to do it any other way, even though my husband and I have very good careers. With that said, we have been paying for our policies for sooooo long, without them having to pay for very many things, including our children!! It makes me very upset that I meet the national health institutes guidelines but a money hungry agency is going to dictate when and if I can have the surgery. I thought they worked for us, not the other way around. They have no concern for our health, it is all financial. Good luck with your journey. I hope you are able to get it done!!!
        
Jaybee766
on 4/9/12 2:48 pm - Silver Spring, MD
VSG on 02/27/12 with
Hang in there!  Sorry it's been delayed but for me those 6 months FLEW by!  After the tests and the consults to prepare me for what to expect - it literally seemed to go by in a blink of an eye. 
You're not alone!
Jeanne 

Height 5'7"   HW: 314     SW: 293

        
tracy L.
on 4/9/12 2:53 pm - PA
RNY on 05/21/12 with
Thanks Jaybee I have three of the six done so what's three more?? I can wait, right? All my testing is done and now its just wait and wait some more! I really hope that when BCBS has their board meeting, maybe it will change and so it won't be quite as long. I was told today, most insurance companies are dropping the six month diet. I have never been very patient so what a lesson this is!!!!
        
melly37
on 4/9/12 3:02 pm - Rio Rancho, NM
VSG on 04/03/12
Dang, Tracy!!  I am so sorry!!  I know that if I was told that, I would be wanting to punch someone.  My boyfriend always offers to let me punch him when I am upset, so maybe you can punch him, also.  ha ha

Seriously.  May is only a month away, hopefully, they will take down the 6 month hoping-you-decide-no period.......uhhh, I mean supervised diet period.  (((HUGS)))


  LapBand Surgery 01/10/08, Revison to Sleeve 04/03/12

tracy L.
on 4/9/12 3:12 pm - PA
RNY on 05/21/12 with
Hahahahaha!! Melly, you are too funny!! Punching something might be a good idea) I sooooo am holding onto hope that in May BCBS will make some positive changes!! If not, only two more appointments after May!!! How are you feeling?!?!?! Plumbing on the mend??
        
melly37
on 4/9/12 4:01 pm - Rio Rancho, NM
VSG on 04/03/12
LOL yes, plumbing is working a bit better now.  *Whew*

Still holding out hope for you!


  LapBand Surgery 01/10/08, Revison to Sleeve 04/03/12

tracy L.
on 4/9/12 4:05 pm - PA
RNY on 05/21/12 with
Yay!! Glad to hear you're doing better! You could always announce it as an nsv)
        
melly37
on 4/9/12 5:16 pm - Rio Rancho, NM
VSG on 04/03/12
ha ha ha ha

Hmmmmm, naw, I think not. 


  LapBand Surgery 01/10/08, Revison to Sleeve 04/03/12

tracy L.
on 4/10/12 4:02 pm - PA
RNY on 05/21/12 with
Lol, just a thought Hope you are feeling good today!! Have you heard of DaVinci sugar free syrups? I just received the four bottles I ordered. Yummy!!!! I am thinking they will be my savior when two week liver reduction liquid only finally gets here. Helping me to cut sugar now!! I got chocolate, peanut butter, raspberry and cookie dough. Can add them to anything, milk, yogurt, tea, coffee and protein shakes. Tons of flavors. Sweetened with splenda so no sugar alcohol effects) of course, maybe sugar alcohol effects are what your plumbing needs!!!! Lol, I will quit picking on ya!! Chat soon!
        
melly37
on 4/10/12 6:46 pm - Rio Rancho, NM
VSG on 04/03/12
ha ha, you are too funny, Tracy!!  I promise you this, when you finally get the nod for surgery, I am going to be  your biggest cheerleader!!

Yes, I have some of those syrups.  I love the cocunut and pinapple flavors, I will put them in a vanilla protein shake ...sometimes with a bit of banana or real pinapple (not right now though). OH YUM!!  Pina Colada!! 


  LapBand Surgery 01/10/08, Revison to Sleeve 04/03/12

tracy L.
on 4/10/12 6:53 pm - PA
RNY on 05/21/12 with
Give me an M, Give me an E, Give an L, Give me an L, Give me a Y!!! What's that spell?? Melly!! Go Melly! Whooooo I will be yours cuz I have sooooo much time on my hands) I know its shocking cuz of my very original cheer, however, I have had no formal training Nitey nite friend! Get some rest
        
sweetishgirl
on 4/9/12 10:04 pm - Colorado Springs, CO
Hi,
I saw your posting on the VSG forum and I also have BC/BS of Pittsburgh.  I requested some information on bariatric surgery from them and according to my summary page-they don't even cover VSG if the patient has a BMI of under 50.  When I spoke to a representative and asked if the sleeve was covered if I have a BMI of 43 the lady on the phone said "If the summary page states you need to have a BMI of 50 or more than I would say no". 

I would make sure your ins. covers you based on your BMI.  I am now confused, because I also, was concidering the sleeve over gastric bypass.  Any helpful insurance information you can send my way would be greatly appreciated!!!

tracy L.
on 4/10/12 4:40 pm - PA
RNY on 05/21/12 with
Hi Sweetishgirl! My policy does indeed cover the sleeve, started covering it last year, November I believe. When I spoke to a customer service representative initially, she was clueless- could not even pronounce the names of the surgeries. My surgeon was the one who informed me that had changed so I called and requested their medical policy regarding weight loss surgery. Now, the clueless customer service rep. who thought it was not covered had told me that if your surgeon recommends a particular procedure, the medical person at insurance company will consider the surgeon recommendation. I don't know how true that is. BCBS is very frustrating because every policy and state are different and they seem to be able to change things at random. There is a helpful book you can get thru Amazon.com, Weight Loss Surgery for Dummies. My advice, ask them to mail you the policy and if you need to speak with anyone on the phone, write down names, request a supervisor as much as possible!!! Good luck and let me know how it goes for you
        
ilex
on 4/9/12 3:16 pm - Garland, TX
Yeah the "hoping you decide no", and/or "hoping we no longer insure you in 6 months" diet.  Sorry OP...that stinks.

 
VSG 12/30/11 Dr. Stewart

tracy L.
on 4/9/12 3:47 pm - PA
RNY on 05/21/12 with
Ha!!! I like that!! Will pass it on to my surgeon's office!!
        
chiefsgirl3
on 4/9/12 3:16 pm - IL
VSG on 06/05/12
 I work for BCBS IL and thank goodness they took away the 6 mos of supervised diet earlier this year!!  I know a LOT has to do with each individual employer group, however sometimes it is a corporate wide mandate. I wish you luck on your journey!  
        
tracy L.
on 4/9/12 3:51 pm - PA
RNY on 05/21/12 with
Hi Chief! It boggles my mind how the requirements aren't more standardized, regardless of which company. It should be based on National Health guidelines, not money suckers!! I have heard from many people on here that their BCBS dropped the six month clause, figures I would have the douche bags that pick it up!! Oh well, I am not going anywhere....neither is my weight for that matter
        
chiefsgirl3
on 4/9/12 5:46 pm - IL
VSG on 06/05/12
 Lol!!  You are so right!  I don't know why at the very least the insurance companies don't have a standard. So much harder to control each different employer. I wish that there was a standard all employers had to follow. Especially for any service that is for a serious health condition.