worried
Hi everyone, well here it is I thought I was(5 ft6.5 in) with a BMI of 40.2 but when my husband checked my height I was 5.5 don't know if it is right but if it is then my BMI is 41.26 either way I'm worried because my insurance wants me to do a 6 month medically supervised diet program. If I lose to much it will put me in the lower bracket so then I will need at least 1 commodity. I have 3 but Medicare won't recognized one of them, and my other two is boarder- line and is being taking care of with meds. I hate to go through all this and find out that I don't qualify. I'm not sure if Medicare will say anything about the meds taking care of the other two or not but they only cover 80% so my other insurance will have to pick up the rest and they said if the meds are taking care of my other problems then it doesn't count. Very worried. Has anyone ever had this problem. And how do I not lose to much so I will still qualify? The WLS center is calling me tomorrow to make an appointment to do a half a day with taking to them and not sure if I should make the appointment or not. Please help. Thanks
Hi everyone, well here it is I thought I was(5 ft6.5 in) with a BMI of 40.2 but when my husband checked my height I was 5.5 don't know if it is right but if it is then my BMI is 41.26 either way I'm worried because my insurance wants me to do a 6 month medically supervised diet program. If I lose to much it will put me in the lower bracket so then I will need at least 1 commodity. I have 3 but Medicare won't recognized one of them, and my other two is boarder- line and is being taking care of with meds. I hate to go through all this and find out that I don't qualify. I'm not sure if Medicare will say anything about the meds taking care of the other two or not but they only cover 80% so my other insurance will have to pick up the rest and they said if the meds are taking care of my other problems then it doesn't count. Very worried. Has anyone ever had this problem. And how do I not lose to much so I will still qualify? The WLS center is calling me tomorrow to make an appointment to do a half a day with taking to them and not sure if I should make the appointment or not. Please help. Thanks
Im new here. Im from Ontario Canada. Is there anyone on here from the area?
Hi, while I can't reassure you that everything with your ins will go ok I can let you know you are not alone. I am in kind of the same situation. My last appt for my 6mo mswl is April 29!! You should contact your ins, some ins have guidelines as to what they want you to lose during the 6mo and so forth. Mine in particular doesn't have a set "lose this much" it is a "we do not want to see you gain any weight". Also from my understanding just because your meds control your disease doesn't mean you don't qualify for surgery. Your diagnosed condition is what you have and the upside for your ins should be that once you have surgery there's a good likelihood you could not have these conditions any longer nor need the meds :) I wish you the best. Go listen to what they have to say it couldn't hurt right?! Best of luck!
I understand.. I was pretty worried myself, as I was not sure if my BMI would be enough, as I am at 40, and 6ft 2inches, and have no other co-existing conditions.. that would be an automatic OK.. like Diabetes or high blood pressure.. However.. I believe it is part of the "protocol" to do a 6 month trial.. just to get the approval. I had to do sessions with a nutritionist.. My thoughts are this.. if your obviously heavy enough to want the WLS, and evidentally other steps did not help.. than it shouldn't be to hard to maintain your weight, and proceed.