Devastated by UHC

I got a call from the Mayo Clinic yesterday and they said my insurance requires a 6 month supervised diet within the last 12 months. I had a lap band in in 2008 and we moved in 2012 because I couldn't eat with it always throw up. when I had it taken out I told the doctor I was so fed up with constantly throwing up and feeling ill that I didn't want to revision and I wanted to go it alone. So I hired a trainer to put me on a meal plan and after working out with him for about 5 months I was in so much pain extensive testing and they determined I have myofascial pain syndrome. essentially the weight training was causing severe pain for me. My doctor recommended I switch to low impact exercises and I quit seeing my trainer which relieve the pain but also resulted in about a 25 pound weight increase. I thought for sure I would have no problems getting approved with United Healthcare choice plus. I am actually about to lose my job and only have about 6 weeks to get this all done before completely losing my insurance and having nothing. I am just devastated by this news

Lapband "removed" not we moved... dang talk to text! 

I am so sorry that the insurance is not working out at this time. Don't lose hope. Perhaps when you find a different job the insurance is better.  There is also always the selfpay option- and the Mexican option saves a ton of cash with good resuts if you researh your docs carefully.  In the meantime, don't give up on yourself.  Focus on good nutrition and exercise that meets your needs. I would see your doc right now while you have insurance to document a month 1 of a diet. I know your insurance is almost gone, but perhaps it could be the start of the 6 month thing and somewhere in there you get new insurance. Many plans require this 6 month period. 

I'm sorry to hear about your situation. I have UHC as well, still waiting for a decision. I would talk to your doctor if they support your decision and have known about your previous weight struggles they might be able to sign off on a 6 mo. supervised diet letter or something. I would try to gather as much evidence and letters of recommendations as possible and just give it a try :) best of luck!

I'm so sorry for your situation...I wish you the best in finding another job quickly.   Will you be offered Cobra from your old job?  We were also going to lose our insurance for another type that did NOT cover any WLS, so we paid for the insurance ourselves, until we were done with the surgeries.  While that's not cheap, it certainly was more cost effective than paying totally out of pocket for 2 surgeries.  We also had UHC choice plus, and had to wait the 6 months. Very common.

good luck, I hope it all works out for you.

Sophie

thank you so much for your words of encouragement. I guess its not a no its just a not right now. Cobra doesn't seem like a good option but I suppose I should find a way to make the payments. The reason I wanted it done with this insurance as I've already met my out of pocket max for the year. I have to start over with a new insurance from a new company I just don't have the money to meet another out of pocket for the year.

Go over the numbers, then go over them again...see if you can manage...it helps that you already met out of pocket.  Good luck Roseygirl!!

I'm sorry to hear about your disappointment.  Unfortunately insurance companies use this six month supervised diet requirement to weed out/avoid paying for WLS.  They know most people will not be compliant and they can reject them for surgery.

My PCP who is a bariatric specialist wrote a very compelling letter to my insurance carrier, Blue Shield of California, citing studies that the six month diet requirement was not a predictor of success or failure after WLS.  He even spoke with the Blue Shield Medical Director specifically about my case.  No bueno.  I still had to do the time.

Not every insurance company has this requirement across the country.  That's what makes it so unfair.  But if you want them to pay, you have to play by their rules.  It's a sad fact of life.

You are right.  It may not be the time for you to have surgery.  Get all your ducks in a row and you'll find a way.  I wish you the very best.  I know that your heart must be broken, but it's not hopeless.  There are options for you in the future.

I would ask your doctor if there is six months of him seeing you about nutrition. Depending on your plan it doesn't have to always be consecutive. Read your plan carefully. 

I hope things work out for you.