thanks for support - appeal to MaineCare denial successful!!

I just wanted to share a bit more about my approval. I originally was denied approval a month ago from MaineCare, and felt this was a fight with the "state". It was really hard on my emotionally, I had failed to lose this weight on my own in so many ways, that I could not fathom losing to a denial of approval. Anyhow, though I could not tell during the actually hearing, she called in as a rep for the STATE, we had a conference call hearing. This woman, Gisele Biron really wanted to be able to approve me and kept in touch with me during the week it took to get the two items from the doctors' that I needed. Then, having received everything, She called me at exactly 8 am on Monday to tell me I was approved. She said she would confirm later as there was a formality that had to be followed by she WAS approving me. And she seemed as happy as I was. Well, she did not call, so I left a message.- nice one. and then called the hearing officer's office and they confirmed that my case had been approved, not knowing this, Gisele called me at HOME on FRIDAY night - she didn't want me to go all weekend without knowing. --Isn't that wonderful!!! If anyone else out there has Dr. Jamie Loggins, could you tell me what you think? What your experience was/is? How long you have had to wait?

Hi Kaileigh, Welcome and congratulations on you approval! Sounds like it has been a long haul for you from reading all your posts. Well, the time is near and you will soon be on your weigh...er, I mean way! LOL

Since I am also on MaineCare, I am curious, why was it so difficult to get approval? I thought it was pretty straightforward with them; if you are at least 100 lbs overweight and have 2 co-morbidities they would approve. Did you have those or do you have some other medical condition that presented a barrier? I always get worried when I hear folks who have difficulty with their MaineCare.

Anyway. Good for you for sticking with it and fighting them!

Thanks for the support. Dr. Loggins listed 5/6 co-morbidities. But they would not accept them as diseases. Though Dr. L. said the codes presented with them are designations of diseases as accepted by national and international medical community. MaineCare is cutting back due to budget issues. so they make your prove you really need it. They told me I had to be twice my target weight not just 100 over. So I actually gained weight for the hearing so I could swear under oath that I was double my target health. I fought hard, if you have diabetes or high blood pressure, heart disease,  etc...than you can qualify easily. I am at huge risk, have depression, ( which is a disease), GERD- which is a disease, etc...high cholesterol, but they woudl not accept. I finally had to prove my obesity was preventing my bladder from operating properly and that got me the approval - they don't do bladder transplants. Let's keep in touch. I have mixed feeling about Dr.Ls approach to me, but his office staff is exellent.

I LOVE DR LOGGINS and his whole team. He may seem over the top careful and cautious but the end results are a quick healing patient. I am so happy I had my RNY I can't even tell you. I would recommend Dr Loggins to anyone without hesitation.

Sorry you've had such a rough go of it with MaineCare!  I AM glad that you won your appeal though!  The road may be full of bumps, but you are on your way!  Congrats!   I had Dr Loggins as a surgeon also!  I liked him from the first time I met him, but now, with all I've been through, I like and respect him even more! (Feel free to read my blog/profile page!)  He is very skilled, careful, thorough, caring, patient, kind....he's just a good guy!  I couldn't have asked for a better, more skilled surgeon!  His team is tough, but awesome!  Corinne, the nut, is very tough and straight forward, but it IS only to make sure we are successful with our tool!  I would never have been able to do this without that team...and without all the people here on OH!  Not sure what his waiting list is like now, but I think he is booking surgery about a month out!  It seems like it may take forever, but, trust me....time flies!  Good luck with the rest of the process and please keep us posted with your progress!  Feel free to ask any questions...I'm still a newbie in all this (so to speak) but there are plenty of others who are much further out and have really good ideas!  Congrats again!!!!  Ruth

oh, Ruth, your not a newbie anymore your an old fart now,  hehe, join the club...

Way to go!!!  Congratulations on your success.

Kaileigh, welcome to the board and to the new world that awaits you. I saw your name and it rang a bell, I remember you fro Politics in Lewiston,  congratulations on finding Loggins, I had surgery 2 weeks monday, I had a lap band, dr. loggins is awesome and I feel wonderful.  welcome and we will see you around. please ask any questions, we're here for you girl.  CHeryl

Thanks so much for the support.How do you guys get those tickers on? I won't need it until the surgery,, but hopefully it will move fast....When did you have your surgery and how much did you lose in the first few months. again, thanks, I look forward to meeting new friends through this site. it can feel so isolating to be fat- just want to stay home.

Cheryl, thanks so much, good to know you have loggins, So your surgery went well? I am such wimp when it comes to pain, I have been wanting to talk to someone from his office that can explain the first month or so, does he give you pain meds, does it hurt alot? I just realized you had the lap band. Is there a reason why you chose that over surgery? Did he pu**** as an option? I've been approved for the Gsomething Y something surgery. Yup politics in lewiston - that was me....