Life-Changing...

Most of you who know me know that I have struggled with diet after diet; losing and then gaining the weight back...  Before we got pregnant with Barrett, I had tried to get the lap band surgery approved through my insurance at the time (Aetna) and my request was denied.  Aetna's requirement at that time was that you had to have a BMI over 40 for at least 5 years, which I hadn't.  It was a really emotional thing for me, because the doctor's office said that I was approved and we scheduled the surgery.  A few days before my surgery, the doctor's office called to say that the insurance company needed 1 more thing... we provided that 1 more thing and the request was denied.  I was very upset by this news.  I joined Weight Watchers, lost some weight, got pregnant, and then yo-yo dieted again for several years. 

I started working for Chase in December of 2010.  After being there for a few months, I slowly started gaining more weight.  I got busier at work, I was sitting more, eating more, gaining more...  In July of last year, I decided to visit a lap band doctor in Fort Worth.  They said that I was a candidate for the surgery, so I completed all of the required visits, screenings, etc.  They submitted the information to my insurance company at the time (Aetna again) and it was denied again.  Now, Aetna has a requirement that you have to have a BMI over 40 for the most recent 2 years.  :(  Needless to say, I was emotionally drained by the ups and downs of this process.  I was denied this time because about 2 years before this request was made, I was on a weight-loss medication that caused me to lose a TON of weight.  As soon as I stopped taking the medication, the weight came back very quickly and of course, I gained more than I had lost (common trend).

This was all in November of 2011.  My insurance was going to change from Aetna to Cigna in January 2012, so the doctor's office suggested that we try again with Cigna.  The main difference in the 2 insurance companies was that Cigna didn't have the weight history requirement like Aetna, so it didn't matter if my weight had dropped; it only matters what it is currently.  And Aetna only required a 3 month nutrition-monitored program, while Cigna wanted 6 months.  (side note: these had to be consecutive months, meaning that if you missed one, you started over)  So in December, I was faced with the question: Do I want to continue seeing the nutritionist and risk being denied a third time?  Some people would say, 'Third times a charm' but others might say, 'This is a sign...'  I really wasn't sure what to do.  I waited until the last possible time in December to make an appointment for that month.  I went again in January for the final visit and then the doctor's office submitted the request to insurance and guess what?   Yep, it was denied AGAIN!  :(  At this point, I really am starting to think it's a sign...

The insurance company needed a letter of recommendation.  Bonham and I thought I might need one, so I had visited our doctor in Abilene when we were down there for our niece's birth.  He said he would provide the letter.  No problem, right?  Wrong...  The insurance coordinator at the lap band office said that I needed a Letter of Clearance for surgery.  I had an annual exam coming up, so I called that doctor's office and asked if they could provide this letter and they said they could.  The appointment was about a week away, so I thought, 'okay, I can wait a week to get the letter.'

I bet you think you know what happened next... :)  I went to that appointment and I was told that they couldn't provide me the letter that I needed.  Comical, I know.  I felt defeated at this point.  It is hard for me to take time off of work and I felt like I was spinning my wheels anyway.  I just felt like this was all for nothing.  So I made one last appointment with a Primary Care Physician that I hadn't seen in over 8 years.   He said that he would be happy to do the letter and he would send it off that very same day.  He sent it in the next day and the insurance coordinator called and said, 'Will your doctor not recommend the surgery?' 
Me: WHAT!?!  What are you talking about???  You told me that I only needed the clearance letter.  I printed off your email, so that he would know EXACTLY what I needed from him!
Insurance Coordinator:  We need both.  Can you call your doctor and ask them to re-do the letter?  Since we are submitting this through the appeals process (since its been denied already), I want to be sure that we get it right.
Me (in my head): Well, maybe if you had done it right the first time...
Me (out loud):  Okay, I will get it done.  (saying it with 'defeat' in my voice)

This process has really taught me a lot about what my customers go through when we are trying to approve their loans, but I try to set the proper expectations that they will be asked for additional items, etc.  Also, insurance companies don't approve with conditions, like we do on mortgages.  :)

So after all of that, I received a call today and... IT'S APPROVED!!!  I'm still having a hard time processing this.  I was told 5 years ago that I was approved and it didn't happen, so I am a little guarded.  I am very excited though.  The surgery is scheduled for March 15th.  It's an out-patient procedure and I am going to take off for about 4 days and then work 1/2 days from home the following week.

I go in for my pre-op appointment on February 29th.  The following day, I will be on a modified-liquid diet, which will consist of protein shakes, soup, sugar free jello, and sugar free popsicles for 2 weeks before the surgery.  In the meantime, I am going to live it up!  
I will try to post more updates. 

Until next time...