Question:
How many people just decided to give up? And what did they do to lose weight?
Since I have been waiting for the insurance because they want more inormation and I couldn't give it all to them. I am am considering throwing in the towel. I am tired of the stress and need to figure out what to do next. Going to Mexico is not a option. I just think God doesn't want me to do this right now. I am going to ask my Dr on Tuesday if there is another drug to try. I need to start seeing her every month for this reason and then maybe in a year if I still am the same way I will have what the insurance wants. a year of supervised diet and documentation. I am just sick and tired of the insurance company that thinks that they know what is best for us. I just needed to vent once again. — Barbara T. (posted on March 19, 2003)
March 18, 2003
I haven't given up but I'm pre op. I started with a BMI of 65.3 and now is
63.9 (I think) .
I have been loosing weight with a 1200 calorie diet and exercise. I have
lost 8.5 in 5
Weeks. I do not drink any soda, no fast food, and no junk food. I measure
or count
everything that goes in my mouth so I have no more then what the serving
allows and I
have no more then 15 carbohydrates per food item. If something has 28
carbohydrates
per serving like rice I will just have 1/2 serving. I'm happy with the
results I have been
getting. If I don't get approved for surgery then I will just keep loosing
weight this way. I
will edmitt I do have one bad food choice a week, just one and I will only
have a serving
size of that bad food. This way I'm not completely denying myself. Best
of luck to you.
— jen091172
March 18, 2003
Don't give up! Try to modify your diet as best you can while jumping thru
seemingly insurmountable insurance hoops, but don't let THEM dicate your
choices in life, IF you are fully committed that WLS is the right choice
for you. I hate to admit it, but life (at least as it relates to food) is
so much easier post op. It puts in place mechanisms and mindsets that
naturally thin people were luckily enough to be born with. Whatever
happens, I am wishing you success...
— rebeccamayhew
March 18, 2003
I am not questioning your decision or at least I am not trying to but why
not appeal. Whats the worse they could say No. You seem to be letting them
make the choice for you> I know how stressful waiting can be. Maybe God
wants you to persevere in this. Well, either way you will have support,
mine included, for what its worth from someone who doesn't really know you.
I wish you the best of luck ion whatever you decide to do. I will say and
this is more about me that when I do not want to confront something I back
off. Talk to your dr and see what he says. Good luck
— snicklefritz
March 18, 2003
It sounds like the insurance company wants a 12 month doctor supervised
diet. Don't think of this as giving up, think of it as another step in your
journey. Yes, start seeing your doctor every month, get the documented
medical diet. Keep reading this site and keep your eyes on the prize. Peace
be with you.
— Sunny S.
March 18, 2003
Barbara, I think you should consider responding to the insurance company.
They have not denied your request. Why not write down every diet you can
remember trying, how long it lasted, how much weight you lost and then
regained. If you have co-morbids (or the beginnings of problems - high
blood pressure, diabetes or a family history of this, arthritis, etc.)
include that. Insurance companies will listen if you bring it down to
dollars and cents: it would cost less in the long run for you to have
surgery now, rather than wait until you fail at yet another diet and your
health possibly worsens, and they have to pay for your treatment of heart
disease or arthritis, etc. Email me if I can help in any way!
— koogy
March 19, 2003
I would say FIGHT IT! They are hoping you will throw in the towel.
Getting approval is a pain in the @ss...I know from experience. If the
surgery is really important to you, do what you need to in order to get
approved.
Kimberly
— Kimberly S.
March 19, 2003
Please don't give up. I spent so long going back and forth with my
insurance company and them asking for more information. I was really upset
because I wanted to move forward. I didn't have what they wanted, but I
couldn't appeal because I hadn't officialy been denied! It was just
ridiculous. Finally I submitted a packet to them and I called and told them
'Look. This is all I've got. Base your decision on what I have sent to
you.' At that point I got a denial letter and I was very upset. I waited a
few months and then started the appeals process. I was approved on appeal
(and they never did get all the info they asked for). I am so happy I
didn't give up. I have lost 140lbs in just over 8 months and I am so happy
with my life. And before I appealed I was going through all the motions and
going to the doctor every month to get the documentation I needed. I told
my mom I was giving up, that this was never going to happen for me. My mom
said, "You know I'll back you 100%, but I have to tell you that's just
nuts. Why would you stop now? If you quit going to the doctor, a year from
now you'll look back and realize, 'If I had just kept going to the doctor I
could be approved for surgery by now.'" Sometimes you have to hear it
from Mom before you really get it. So whether you decide to appeal or
continue with doctor visits, don't give up hope. It can happen for you.
Feel free to e-mail me anytime.
— Jenny S.
March 19, 2003
I gave up once. I had to see this @ssh0le doctor at the military base where
I get my care. He ridiculed me, patronized me, and just generally made me
feel like a fat, out of control idiot. I cried for a whole day after seeing
him. THEN, I went back to see him again after doing what he suggested, and
he made me feel like crap AGAIN! I told my husband that was IT, I was NEVER
going back to him, even if I had to live the rest of my life even MORE fat.
I gave up on the whole thing, and didn't bother to return the clinic calls
or anything. Then about a year later, our of the blue, a new nurse from the
clinic called and asked if I was still interested in the surgery. I said
yes, but NOT with THAT doctor. She said she'd get me in with the other
doctor, but I heard he was WORSE. I went anyway. I absolutely ADORE the
other doctor, and had the surgery 2 months later. If I had just TOLD
someone else that I wanted to see the other doctor, I wouldn't have had to
wait so long. I was being stubborn, and afraid. Don't let that be YOU!
FIGHT for what you want. Don't let the bastards grind you down, as my dad
would say. LOL!
— Diana L.
March 19, 2003
there are ways around the supervised diet thingie. everytime you go to the
doctor(last 10 years)they should take your stats. you can use this also as
proof of being overweight. it will show your loss and gain over the years.
good luck.
— k K.
March 19, 2003
I just read your profile and you said that you had been denied but they
asked for more information. That is not really a denial. They're just
saying they don't have enough information to make a decision. Unless, by
more information you mean things like a supervised diet, nutrition
counseling, etc...things that you can't provide them. If that's the case,
first, get in writing from them exactly what you need and see if your PCP
can provide any of that information in a letter (unless, like AETNA it must
be documented in the medical records).
You don't mention what they wanted specifically that you couldn't provide.
If it is proof of morbid obesity for 5 years or something that should be in
a medical record but just isn't in the PCP's records, what about trips to
urgent care, emergency rooms, gynocologist, local health department, etc.
Regardless, don't give up. If you meet their criteria but just haven't met
the requirements, just work with your doctor and the insurance to get the
requirements met.
Good Luck
— Carolyn M.
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