Hello from a newbie!

Hi everyone!  I found out that this site has message boards by state completely by accident, and I am so incredibly glad that I found you!

I am hoping to have gastric bypass in the future.  My BMI is 35, but under 40.  I have a degenerative joint condition, which qualifies me for surgery.  My insurance, Blue Cross MN, is requiring me to see a dietician for 6 months.  Today I have my 4th month appointment, I am excited!

I am feeling a little nervous, though, because a co-worker with the same insurance just got denied, and her BMI is 44.  She's pretty upset after going through all the hoops that Blue Cross makes us do, and her surgery center is going to try to work with Blue Cross to get them to cover it.  But I wonder, is this a common thing?  That insurance will deny you after you have done everything that's required and also meet their criteria? 

I am glad to be here!

Leah

Welcome,   I have BXBS and have a high BMI but no other medical issues, I don't know much about being denied, I was approved after I did the psych visits and 6 month nut. visits.  She will have to find out the reasons for denial and appeal.

Are you doing the lap or RNY?

Snowflower, HI!

I am going to have RNY -- I have some issues with acid reflux, so it will likely help that as well.  Otherwise, I am not sure why, but I have never felt like lapband was right for me, personally.  And I need to go with my gut, right?  (Haha!  Sorry, that was a pretty bad joke!)

Welcome to the board, and good luck on your journey......Make sure you check out one of the many coffee get togethers....Lots of support & fun....

Kelly

Hi Leah - welcome to the boards!

It is not at all unusual for someone to be denied after their first try.   If you think about it from an insurance company's cost-control perspective, if they can say no and the prospective patient accepts that, they don't have to pay for surgery! (I won't go into the cost of treating all the co-morbs, it's too ridiculous...)

But many times, a denial can be easily over-turned.  And sometimes, it takes a super-human effort to get a denial overturned.  But if you truly to believe that this is your answer, DON'T TAKE NO FOR AN ANSWER!  If your surgeon agrees you are a good candidate, have them back you up!

Good luck to you - I hope plenty of people who have had to fight that battle chime in here (I was one of the lucky ones who got shuffled through with no trouble at all...)

WELCOME to the board!!!!!!!!!!!!!  Good luck to you and keep us posted!!!!

Marsha

Welcome Welcome Welcome!!!

I second the advice to check out the "coffee" nearest you.  It puts faces to these boards and gives you a chance to get the hugs you need too!

Let me know if there is anything you need.  I'm laid off, so we could even meet.

I am pre op and waiting for my date.  Dr. said yesterday that I will probably have it the beginning of Dec, so not too far to go!!

Again welcome.  These people are great people!

Welcome!  Support groups are the best and I have come to regret not attending regularly over this  past summer when we seemed to be busy every time there was a meeting scheduled.  Good luck!

RP

 Welcome to the board.  I am also very new to this board and just had my surgery a week ago.  I also have blue cross blue shield MN insurance.  All I can say is to have the person appeal.  I had a high BMI - 71 (at my highest weight) with at least one other conditions, and was approved on the first try.  The dietician visits can drag on, so keep your head up.  I ended up having 9 months of visits were not successful until i transferred clinics and proceded to lose 70 pounds (in 3 months) before my surgery.  Have a nice day and keep us updated.

Jeff

Hi Leah, Glad to meet you.  I hope that the insurance person at the office can get all the papers approved.  Do not give up.  Appeal is possible.

Hugs, Kathy