Hello im new here and kinda nervous.

stard
on 8/16/08 4:59 am - canton, OH
i have just been denied by my insurance company because of an exclusion in the policy, even though my BMI is 54.4. I am so discuraged. i no that i cant live at this weight forever but im just lost. can anyone give me some advice on what i should do now. im desprate. please help!
jdruski
on 8/16/08 6:02 am - Philadelphia, PA
Can you talk to HR and get them to drop the exclusion?  If not appeal.  Even if it means showing up at the insurance company's office and showing them how you are struggling and suffering at your weight. 

Keep at it.  I know this a discouraging set back but keep fighting. 


Good luck.


Jeanne
Patty T.
on 8/16/08 8:03 am, edited 8/16/08 9:58 am - Boalsburg, PA
While you are fighting your insurance company, you can also take steps to better prepare yourself for surgery.

1. Start logging your food. Watch what some of the folks here post - it's helpful to learn to eat like a WLS patient before becoming one. Increase your protein. Decrease your carbs, esp. the refined ones such as sugar or white flour.

2. Work with your PCP to start documenting your weight. Some insurance companies require a 6-month supervised diet. In may cases, if you start that now and be sure it is documented, that may help you move ahead in the surgical queue a bit faster once that time comes.

3. As with food, start making changes in your activity level. If you can't stand up for long (I still fatigue easily), find some chair exercises. Get a pedometer and measure your steps. Don't go for a walk around the block at first - start with smaller goals. Listen to your body, but try to move it each day, even if it is just household chores.

4. If you can afford it, you can self-pay for the surgery of your choice. Prices vary around the US and some folks have also gone out of the US.

5. Water is your friend. Drink it - a lot! I like to think that it helps wash away the fa****er is also a nice place to exercise. You can do water walking, water aerobics, swim laps or just play. I know that it can be difficult to walk around in a bathing suit in front of hardbodies, but I've found that most of the water aerobics classes I've been to have at least 1-2 other people my size or bigger.

6. Join a health club and go during off hours. Daytime is senior time at my club, and I've found that most of the seniors are much more accepting of differently shaped bodies.

7. Don't give up! Come here for help and support. Ask and learn in the insurance forum - you may get the info you need to appeal. Post and become part of the community here.

Best wishes, Patty



stard
on 8/16/08 10:17 pm - canton, OH
Thank you all for you advice. i plan on using every bit of it. it really does help to reach out to people who can understand. im thankful i have found you all.
Jeanine F.
on 8/18/08 9:44 am - Clifton Park, NY
Keep after them and don't take no for an answer. Some times simple details are overlooked. Good luck!  Jeanine


  


jiji21
on 8/19/08 10:06 am - fort stockton, TX
I was denied for the same reason.  I didn't appeal it thought.  I saved every penny and got some help from my family but finally came up with the money to pay myself, 2 years after I started.  Don't give up, it will work out.  There are also medical finance companies...it's like financing a car, haha.  If you want it bad enough, you'll find a way.  Good luck to you!!
stard
on 8/22/08 3:56 am - canton, OH
Thanks for the encouraging words. i have looked into self pay but it just seems so unaffordable right now, the payments would be so high to borrow that kind of money. im not gonna give up on myself though. Hopefully it will all work out. thanks again.
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