I started this journey years ago, I had VBG surgery back in 1999 and was sucessful having lost almost 200lsb. Over the years the VBG and I failed. I knew the long term sucess for VBG surgery was not good but it did restore for health for a period of time.
I finally found myself close to 450lbs in the fall of 2005. In Feb. of 2006 my Doctor sent me to the Surgeon's office to have a revision to RNY. This is where my fight with the insurance started.
I had high blood pressure, asthma, severe obstructive sleep apnea, severe knee pain, swelling in my lower legs but still even after completing my 6 month supervised diet I was denied because of no medically necessity. After my sleep apnea study was done the Docotor called me in immediately and told me that I was one of the worse cases he had ever seen. My O2 levels with CPAP & O2 during the study dropped as low as 55%. I was told that I was very lucky that I had not already died in my sleep. Imagine hearing this and that to have an insurance company tell me that bypass surgery was not medically necessary. You want to know what moron of an insurance company said this, I'm not bashful it was Cigna.
I lost even my external appeal because they felt I was not compliant with the VBG from years ago. The real reason was they did not have the letter from my previous Surgeon who stated " Tom has been very suceessful loosing weight and excersise".
All of this happened near the end of 2006 and Cigna knew in 2007 they would not be covering WLS for my company. I was very fortunate that my company switched my coverage after open enrollment had closed. It only took 3 days after submitting my paperwork to UHC and I was approved.
Last year has been one of the worse years in my life dealing with insurance companies and being suchbad physical condition. The pain, depression, not being able to breath, and almost being made imoble to the point of not working has been terrible.
I thank God for the strenght and keeping me from falling off the deep end. I never fail to pray each night when I lay down and thanks him for one more day on this earth. This website and all of the people here who have had to deal with the samething has kept me going. My current BMI is 79.1 and I was at 477 lbs on my last weight in. I started trying to diet again 2 weeks ago and have managed to loose 15lbs. I'm going to keep it going so that I can hopefully make my chances of surniving surgery. What ever happens I know that I'll be okay. I'm actually feeling real good lately. My asthma is under control, my depression is under control, and I'm walking further distances without having to stop every 75-100 ft.