I am not in any kind of rebellion against the delay. I can't get in to meet with the surgeon until November and his office gal has me on a list if there is a cancellation. I can be over at his office in 5 mins. I work at the hospital where the surgery will be performed, so I know how busy our docs are. The 6 months of physician supervised weight loss sessions is a requirement of the insurance and will not be waived. They are cracking down on a lot. I have a procedure done on my back and since it is for fibromyalgia and soft tissue (in other words they can't look at an MRI and say I have a slipped disk, etc), the insurance ruled that the last time I had it done it was deemed "not medically necessary" and that in the future, I would have to get it pre-approved.
Mind you, this is a covered service. They changed policy mid-term (our insurance renews in January!!). I am in a PPO and can self-refer, but they are now requiring referrals for everything!!! Heck, I am in an HMO in all but name only. I feel for our lap-band patients. Our insurance will pay for RNY or lap band. For lap band they now have changed their tune and will only pay for two fills for those patients and it cost $600.00 a fill (there is a lot involved, contrast swallow tests, etc. when they do each fill). Our plan will pay up to $20,000 for weight loss surgery and related expenses. Then we are on our own. Scary, right?
Oh, and those 6 months of visits of course are another 6 months of bills they are going to have to pay out with the end result being the same. Thing is, we all better get used to it because the insurance companies are really cracking down on all kinds of things and sad thing is, these are legit. diagnosis and treatments.
I am not upset about the 6 month wait. I have started to change my eating habits and make some healthier choices. I have tests I need to have run. I was recommended for this surgery a year ago, and I was not ready then. I spent that year doing research, reading, working through some things, so while I am continuing to do reading and learning things (we never stop learning new and wonderful/helpful things), mentally, I am ready.
I am also using this time to get my house in order. I have been remodeling. Yes, I was given an exercise plan from my doctor at our first meeting. Currently, my exercise plan is painting, furniture moving, installing flooring, etc. (and taking Advil and Tylenol!!) Next month or shortly into the next month, I hope this renovation will be complete and then it will be on to the fall garden preparations and leaf raking. After that the basement and garage. Since I know I won't be able to do a bunch of heavy lifting post surgery and because this is one of my steps in getting things together in my life (this has been major stress for me - my house not being in order), I need to do this now. I need to off-load the clutter, just like I need to off-load old recordings from the past that rear their ugly heads from time to time. Time for a fresh start. This is the start of my new life. My new path.
The surgeon's nurse also told me it was ok to lose a little right now, but not to go crazy for the very reason that the insurance could deny my surgery. She also said, and yes, I totally agree with her, if I could do this without the tool of the pouch, I would have long ago. I know I need this, so for now, we work the system. Loose a little at least until I meet with the surgeon in November and once I have his pre-surgical recommendations, then things will be more settled. Thanks for the ideas Cindy. I do appreciate it.
Live well, play hard and enjoy life. It really is too short.
| Pounds lost: 129.0