Weight Loss Surgery Directory

Accused of sailing the system?

I had a class yesterday, and today I went and did the gym tour. A lady asked me if I was trying to sail (scam) the pathway Tricare that insurance has in place. In order to have WLS you go through 4 classes and 4 workshop type things. Well the classes are every tuesday and then the workshops are on Wed. 

She talked down to me for being at the gym and said that I am supposed to only take one of the classes OR the workshops ONCE a month!!! Then she told us how one lady finished everything in April and they are now pruposefully making the lady wait until Sept before making an appt with the surgeon because she needs to let it 'sink in'.

I have 4 kids, one of which is a breastfeeding infant. Me getting any of these classes done is an act of God itself! 

Has anyone ever heard of something like this???

Katie. Proud Navy wife and Momma of Chloe (8) Julianna (6) Kaylee (4) and Paige ♥ born April.9.2012

  

What a snot head! Whats it to her that you go to the classes?  She should be happy to have you and encourage you to come as much and continue with the classes, not be judgemental! I haven't heard of that but thankfully I have cigna primary and tricare is my secondary so I haven't had any problems with them.  You do what you need to do and forget about her!  And you aren't "sailing" thru if you are doing what they ask of you to do you are simply following the directions given to you.  Did they give you a manadatory time limit? If not then do what you can.  Good luck
It was definitely that woman's own insecurities talking!  Unless the guidelines specifically state a timeframe, I'd not waste another second worrying about what she said.  People and their control issues!

   
What a jerk! I made my decision in March to have VSG and had my procedure in April. I took in so much information in that 4 weeks my head was spinning. My insurance did not specify any time frame for taking classes, only the supervised weight loss. If you feel they are intentionally delaying your procedure to "left it sink in" I would kick an appeal up to the Insurance Commissioner in your area. This should help them to "let it sink in" that they cannot do this.
Don't give up! Check you guidelines and then do what they say. Here's to hoping we see you soon on the losers bench!