Yep, they denied my request to be covered for lap-band surgery. Total bummer. I actually found out on Monday, and it has taken me until now to clear my head and be able to talk about it.
I was denied based on my lack of health issues. basically I am too healthy for the surgery (not too fat, just too healthy). nice.
I could appeal it. But honestly, the letter was pretty clear and I don't think an appeal would help. Plus I am just emotionally done. The 2 weeks waiting to find out left me stressed and cranky. Not to mention unproductive. I am just ready to move on. I tried.
At first there were tears. Steve and others were super supportive and helped me see that I was going to have to do the work anyway (watch my food & exercise) and the band was just a tool. And I can most certainly still achieve my goal without it. It would have been nice, but it wasn't meant to be.
So I am moving on. I started back on plan yesterday. Took new "before" pictures, weighed in (340).
My biggest fear (and the reason I wanted the band to begin with) was not starting or even getting some weight off, it was just that I always start strong and then something always gets me off track. I wanted the tool to keep me on track and help me not to re-gain. So many people regain after they have lost weight. And it's crazy because often it's after having kept the weight off for quite some time. But that ship has sailed.
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- Sandi
- I started this blog 200 lbs overweight. I now have under 100 lbs left to lose. My goal was to save my life by losing weight and become the active, fun loving woman I was inside. I am most of those things now, but have a ways to go! Join me as I blog my way through this journey.
Stats
Age: 44
Highest: 368 (7/12/10)
Current: 259.2 (7/9/12)
Goal: 168
Total Pounds lost: 108.8
Highest: 368 (7/12/10)
Current: 259.2 (7/9/12)
Goal: 168
Total Pounds lost: 108.8
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4 comments:
Sandi, I had a big rant posted and then I deleted it because I decided that it just wasn't anything you really wanted to hear. Let's leave it at that I am stunned and shocked and angry that you were denied the surgery. I think you should appeal and if you decide to do so then try getting some help at obesityhelp.com, they know all the ins and outs of insurance companies and how to wrangle with them. It has been an emotional time so you might change your mind after you've had a chance to cope with what has happened. Best wishes no matter what you decide to do.
Jen
It never ceases to amaze me how insurance companies are not interested in preventative measures. Does it not make sense to them that the relatively cheap outlay to cover lap-band could avoid them having to pay out quadruple that cost in the future if your weight did lead to serious health issues? Its bad business practice. I don't expect insurance companies to give a crap about the emotional well-being of the people they cover, but you'd think they'd have some business sense and care about the physical (costly) well-being. Geez.
Well, you'll show them! You'll do it on your own and ensure your own healthy future without their help. Yes, it would have been a helpful tool - especially once the weight has been lost (coming from someone who lost it all and has battled with gaining, losing, gaining, losing ever since). But, as you know, having lap-band doesn't mean you can eat what you want - food would have been restricted in any event. So now you put an imaginery band in there.
Of course lodging an appeal is attractive in that you have an opportunity to make them see common sense and how you shouldn't be punished for being healthy and wanting to stay that way (thus saving them dollars).
Whatever you decide to do, always keep in mind you have support from real people (not clueless account executives) who want what's best for YOU!
Jill
That sucks Sandi. I was hoping for you. You are doing well in that you are now working on a new way. Maybe this is the catalyst you need that will help you stay on track. What has really helped for me this time is I didn't set any timelines for losing weight and am instead focusing on my habits. If I never get to 150, I'm okay with that. My only goal right now is to get below 200. After that, we'll see where this journey takes me.
Ohh, Sandi! I'm so sorry!
How frustrating...insurance companies can be pure evil sometimes!
Have you ever watched the show Big Medicine? It's a show about two father and son surgeons who help people like us. Here's the link...I'm just wondering if their site, or even they themselves could offer any advice/help...
http://tlc.discovery.com/tv/big-medicine/apply.html
I just feel terrible that this has happened, and really want to give you a big (((hug))) my dear friend!
xoxo
Linda
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