Denied by insurance for gastric sleeve today :(

MichkaMeShell
MichkaMeShell Posts: 34 Member
in Health and Weight Loss
I got the call today. I was denied by my insurance company the coverage for the gastric sleeve. The reason? I've lost too much weight during the 3-moth process in which I had to attend a class once a month that educates you on the lifestyle change you will be embarking on. This was required by my insurance company in order to attain their coverage.

Despite being told by the doctor, nutritionist, and insurance lady that weight-loss BEFORE surgery is preferred and even some-what mandatory, in some cases. And, despite being reassured not once, but three times that it wasn't going to be possible to lose too much weight before surgery, I seemed to have achieved this task.

I did everything I was supposed to. I did what I was told and I started taking charge of my life. Now they're telling me I took too much charge and I no longer have the privilege of their services.

It's bitter-sweet. I mean, who can't be a little proud of losing nearly fifty pounds? At the same time though, I was REALLY looking forward to having another weapon in my arsenal for when my Will Power gun was running low.

I can't say I'm ready to just give up or anything pathetic like that. The thought of launching myself into a downward spiral seems rather annoying and self-mutilating.

Has this happened to anyone else? Can someone share their story with me? I still feel strong....almost like this is a sign I should be doing this on my own....or a sign that surgery might lead to something far worse.
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Replies

  • ironanimal
    ironanimal Posts: 5,922 Member
    Well, clearly you don't need surgery then.

    You're 22 for christs sake. You can achieve anything you want if you put in the work. You don't need shortcuts like that. It's a good thing you were rejected in my opinion. You have the strength to do this without medical intervention.
  • aaron145
    aaron145 Posts: 2
    I like your attitude. I not a candidate for gastric sleeve, but I wanted to just say that I can see how what happened is bitter-sweet. I hope to be able to do what you've done to lose the weight. Keep going :o)
  • beachlover317
    beachlover317 Posts: 2,848 Member
    I would be disappointed as well. But good golly! Look what you have already done! Without anything but your determination! What will happen in another three months? How much will you lose? In another three months after that you will be close to your goal weight! That's fantastic! If you can do this on your own and with the support of your friends on MFP, you will be eliminating a major surgery with tons of follow up. You have already begun setting up your life style changes. I say keep going! You can do it!
  • sailorsiren13
    sailorsiren13 Posts: 460
    Well i'm sorry you feel that way 50 lbs. in three months is freakin' amazing!!! it's taken me 6 to lose 14 be proud of yourself and keep up this journey you will not be disappointed!
  • byrnet18
    byrnet18 Posts: 230 Member
    Well, clearly you don't need surgery then.

    You're 22 for christs sake. You can achieve anything you want if you put in the work. You don't need shortcuts like that. It's a good thing you were rejected in my opinion. You have the strength to do this without medical intervention.

    This exactly. Those surgeries do not come without risk. Obviously you are strong enough to do what it takes to get the results you seek. Just work hard and in no time you'll be a happy, sexy, healthy you.
  • Christine1110
    Christine1110 Posts: 1,786 Member
    I'm so sorry you got denied, but You can do this! You have lost 48 pounds, so you can do it!! You will really feel good when you have done it on your own : )

    Good luck on your new journey!
  • bjfmade
    bjfmade Posts: 543 Member
    Take it as a blessing in disguise. You have proven to yourself that you CAN do this, so continue to do it and it will be so worth the work! You will appreciate the journey more and not take anything for granted. Keep it up, you can do it yourself! Everything happens for a reason....
  • jzaz903
    jzaz903 Posts: 306 Member
    I would be disappointed too... But as you said, it's really a bittersweet thing. Sad that you can't get the help, but good that you know now you can do this without it.
    You CAN do this. It won't be easy, but you'll have even more to be proud of when you finally get to your goal weight- that you'll know that you did it for yourself, by yourself, without surgical help. I'm proud of you already.
  • lmcadam2
    lmcadam2 Posts: 9
    I can imagine like you said that's bitter-sweet but it seems like you have learned what you need to do! It's great that you don't seem too discouraged! Just stick to it and you will be where you want to be sooner than later! And you will know that you did it 100% on your own and that is always a great feeling!
  • marathon64
    marathon64 Posts: 378 Member
    I understand your frustration but look at this as a HUGE opportunity!! You can DO THIS and without any of the medical risks and complications you might experience from a surgical procedure. While the sleeve is a tool I think that your BEST and MOST ENDURING opportunity to be fit and healthy is to keep up what you are doing regarding healthy diet and lifestyle changes. I am so excited for you about this journey you have begun and I hope and believe you will look back on this as one of those "mistakes" that turned into a huge opportunity. CONGRATS!
  • BrettPGH
    BrettPGH Posts: 4,716 Member
    I still feel strong....almost like this is a sign I should be doing this on my own....

    This is the only voice you need to listen to. Say it. Loud.
  • usmcmp
    usmcmp Posts: 21,219 Member
    It looks like you are approaching the half way point in your weight loss. Congratulations on all you've done so far. It really is a sign that you can do it on your own.
  • jdragione
    jdragione Posts: 18 Member
    Those surgeries involve a lot of risk. If you lost that much with simple lifestyle changes why not continue them and do this naturally? When you are as young as you are the weight will melt off if you keep up with it.
  • jhardenbergh
    jhardenbergh Posts: 1,035 Member
    Very bitter sweet, but great job keep up the good work. You don't need the gastric. It's pretty tough from what I hear. I lost all my weight in a little more than a year without gastric and am happy I didn't go that route. Just stay focused and keep tracking.
  • emnk5308
    emnk5308 Posts: 736
    Take it as a blessing in disguise.. Who knows something might have gone wrong with your surgery =( Keep working hard <3 You'll make it!!
  • amandammmq
    amandammmq Posts: 394 Member
    I still feel strong....almost like this is a sign I should be doing this on my own....

    This is the only voice you need to listen to. Say it. Loud.

    I agree.

    I took a peek at your profile and pics... you are a lovely, vibrant young woman with an amazing future ahead of you. You have taken a big step to take charge of an aspect of your life that will undoubtedly bring you a lot of happiness - you will be healthy, happy, strong, and you will be able to maintain your success. You can do it!
  • EBFNP
    EBFNP Posts: 529 Member
    Honestly, I am happy you were denied. Not because I am being rude, but if you can lose the weight with lifestyle change, why have surgery?Too many people actually get approved for those things and never stepped foot in a gym or changed their eating habits. I wish more insurance companies would crack down on weight loss surgery.
  • irefusetoquit
    irefusetoquit Posts: 62
    Well, clearly you don't need surgery then.

    You're 22 for christs sake. You can achieve anything you want if you put in the work. You don't need shortcuts like that. It's a good thing you were rejected in my opinion. You have the strength to do this without medical intervention.

    This exactly. Those surgeries do not come without risk. Obviously you are strong enough to do what it takes to get the results you seek. Just work hard and in no time you'll be a happy, sexy, healthy you.

    Absolutely! Look, you've come this far without the surgery, what ELSE can you achieve? Don't stop now, keep on going! People here at MFP will be there to help and motivate you. Don't give up!!
    You can do this!!! :)
  • suziecue66
    suziecue66 Posts: 1,312 Member
    I got the call today. I was denied by my insurance company the coverage for the gastric sleeve. The reason? I've lost too much weight during the 3-moth process in which I had to attend a class once a month that educates you on the lifestyle change you will be embarking on. This was required by my insurance company in order to attain their coverage.

    Despite being told by the doctor, nutritionist, and insurance lady that weight-loss BEFORE surgery is preferred and even some-what mandatory, in some cases. And, despite being reassured not once, but three times that it wasn't going to be possible to lose too much weight before surgery, I seemed to have achieved this task.

    I did everything I was supposed to. I did what I was told and I started taking charge of my life. Now they're telling me I took too much charge and I no longer have the privilege of their services.

    It's bitter-sweet. I mean, who can't be a little proud of losing nearly fifty pounds? At the same time though, I was REALLY looking forward to having another weapon in my arsenal for when my Will Power gun was running low.

    I can't say I'm ready to just give up or anything pathetic like that. The thought of launching myself into a downward spiral seems rather annoying and self-mutilating.

    Has this happened to anyone else? Can someone share their story with me? I still feel strong....almost like this is a sign I should be doing this on my own....or a sign that surgery might lead to something far worse.

    You just proved that you can lose weight and a bucket load in 3 months so never needed the surgery in the first place. Just keep doing what you've been doing.
  • shari227
    shari227 Posts: 13 Member
    If I were you I would take this as a blessing in disguise. You can do this without surgery!!!! Hell, we can all do this without surgery! Congratulations, this could be the best thing to ever happen to you!
  • Elizabeth_C34
    Elizabeth_C34 Posts: 6,376 Member
    Well, clearly you don't need surgery then.

    You're 22 for christs sake. You can achieve anything you want if you put in the work. You don't need shortcuts like that. It's a good thing you were rejected in my opinion. You have the strength to do this without medical intervention.

    This exactly. Those surgeries do not come without risk. Obviously you are strong enough to do what it takes to get the results you seek. Just work hard and in no time you'll be a happy, sexy, healthy you.

    Absolutely! Look, you've come this far without the surgery, what ELSE can you achieve? Don't stop now, keep on going! People here at MFP will be there to help and motivate you. Don't give up!!
    You can do this!!! :)

    EXACTLY! You've proven that you CAN do this! So, all that's left is to DO IT!.

    Believe in yourself, and nothing else matters.
  • mbajrami
    mbajrami Posts: 636 Member
    Well, clearly you don't need surgery then.

    You're 22 for christs sake. You can achieve anything you want if you put in the work. You don't need shortcuts like that. It's a good thing you were rejected in my opinion. You have the strength to do this without medical intervention.

    ^ This

    If I would have lost that much in just the few months prior to surgery, I would have elected myself to not have it. I actually had a consult a couple years ago (for the band) and decided it wasn't worth it and if I was willing to have SURGERY to lose weight, I was obviously serious enough about losing to be able to take charge on my own.

    You've made amazing progress already. It's obvious you can do this and I'm sure you WILL. WE can be the extra weapon in your arsenal. Feel free to add me.
  • future_runner
    future_runner Posts: 136 Member
    You are strong! This is affirmation that you CAN do this on your own. There are many people on this site who have lost well over 100lbs. Find them and get some success stories. Then go out be a success story for someone else! You have already accomplished so much
  • happyfeetrebel1
    happyfeetrebel1 Posts: 1,005 Member
    LOL

    I lost 40 lbs pre surgery and was so excited. I did have the sleeve in March

    My Dr. didn't submit all my weight changes to insurance tho..they kept it based on the weight I was for all the beginning appointments; I'm surprised your Dr. didn't.

    I was required to do months of phone counseling with my insurance tho..in addition to the ton of other counseling/dietician/pysch/classes and physicals...they were super supportive.

    You should be proud of what you've accomplished tho..keep it going :)
  • KimertRuns13_1
    KimertRuns13_1 Posts: 702 Member
    The gastric sleeve is just another tool that you proved you don't need. You've lost nearly 50 lbs on your own. Take this moment as not bittersweet but as a very proud moment. You did something that a lot of people don't do before facing weight loss surgery. Be strong and determined and you will reach your goal weight on your own...through a healthy diet and activity. You can do this! You just have to believe that you can. :)
  • littlelaura
    littlelaura Posts: 1,028 Member
    I think you have it in you to do it on your own and you will be better off because of this. It may take a bit longer but its healthier in the long run not to have the operation if you dont need it now. Losing weight isnt easy but having an operation alter your body isnt easy either and so many complications can result. My own Aunt died on the table in her early 20s having this surgery leaving my 1 yr old baby cousin behind, she too thought she was doing something that would better her life, it ended it. If youve come this far, keep going!!! You are worth it!!!
  • yallcallmedeb
    yallcallmedeb Posts: 294
    This is a total blessing!!!! You are going to avoid MAJOR surgery that can be life-threatening and has life-long effects. Gastric surgery (I don't know much about gastric sleeve) is not a guarantee either. While you will lose massive weight quickly, you need to eat a crazy low calorie diet for the rest of your life in order to maintain it. I have a friend who had gastric bypass and lost a ton of weight and has gained back at least 50-100 lbs of it. You CAN do it without surgery! Why would you want surgery that you don't need?

    You are awesome! 50 lbs weight loss is great!
  • murdie
    murdie Posts: 85 Member
    Congratulations on your weight loss! Awsome! Be glad you won't be able to have that surgery! You've got a great start and it will be so much better for you in the long run to do it naturally! Diet and exercise is the big secret to weight loss.
  • Captain_Tightpants
    Captain_Tightpants Posts: 2,215 Member
    You're too good for those quick fix solutions. You've proved you've got what it takes without needing surgery.
  • Troy67
    Troy67 Posts: 556 Member
    I know it seems crappy that it worked out that way, but trust me - be glad. I work on the floor at the hospital where the bariatric patients come after surgery.
    In a lot of cases the surgery can be life saving. If you aren't so morbidley obese that it is the only option, you are much better off. The same patients come back over and over with complications from the surgeries-whether they had a sleeve, banding, roux-en-y, etc. Not to say that its a majority of surgeries that have problems, but it is enough I am glad I never had anything done when I was at my heaviest at 336 pounds.
    I hope the way things unfolded for you are a blessing in disguise and wish you luck in your efforts.

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