Where do we go from here?
Hi all! It's been a really rocky couple of weeks but the depression is lifting and I had a bit of a revelation the other day. I'm going to leave that for a post of its own though. Today I want to update everyone on where I am with things.
Let's start with the basic health stuff. I spent 2 phone calls and a total of about 40 minutes on the phone today with my insurance company. I had some questions and eventually, I got some answers. It just took 2 phone calls and 40 minutes..heh.. I'll save you 40 minutes and give you a quick rundown:
Mammogram: 3D mammograms are covered and I now have this scheduled for next week. I'm not excited but it needs to be done so I might as well get it done.
Therapy: I get 20 therapy visits per calendar year and that number resets on January 1st. It doesn't seem like a lot but I guess it does come out to about 2 per month. I'm still on the fence about going to therapy and what type I should pursue but it's good to know that it will be covered if I decide to seek it out. Of course, I did forget to find out if they have a provider listing. That's another call for another day, I guess.
Weight Loss: For the past couple of years, my doctor has wanted to send me to the local hospital to pursue the option of weight loss surgery. More and more lately, I've come to realize that I need some guidance and some accountability. I don't seem to be able to do it on my own. I've beat myself up over this time and time again. People say that I'm strong, etc but I can't seem to do this. Enough. Sometimes we all need help and I shouldn't feel any amount of shame for that. If you're someone who feels the need to shame me or anyone else, feel free to also find the door.
I was given quite a bit of information...my insurance will cover the surgery if I meet the following criteria:
Let's start with the basic health stuff. I spent 2 phone calls and a total of about 40 minutes on the phone today with my insurance company. I had some questions and eventually, I got some answers. It just took 2 phone calls and 40 minutes..heh.. I'll save you 40 minutes and give you a quick rundown:
Mammogram: 3D mammograms are covered and I now have this scheduled for next week. I'm not excited but it needs to be done so I might as well get it done.
Therapy: I get 20 therapy visits per calendar year and that number resets on January 1st. It doesn't seem like a lot but I guess it does come out to about 2 per month. I'm still on the fence about going to therapy and what type I should pursue but it's good to know that it will be covered if I decide to seek it out. Of course, I did forget to find out if they have a provider listing. That's another call for another day, I guess.
Weight Loss: For the past couple of years, my doctor has wanted to send me to the local hospital to pursue the option of weight loss surgery. More and more lately, I've come to realize that I need some guidance and some accountability. I don't seem to be able to do it on my own. I've beat myself up over this time and time again. People say that I'm strong, etc but I can't seem to do this. Enough. Sometimes we all need help and I shouldn't feel any amount of shame for that. If you're someone who feels the need to shame me or anyone else, feel free to also find the door.
I was given quite a bit of information...my insurance will cover the surgery if I meet the following criteria:
- Co-morbid BMI of at least 40
- Having been in a medical weight management program for 6 months and to have lost 10% of my body weight in that 6 months. The program has to have been within the past 2 years.
- Documentation of having seen a dietary consultant.
- Documentation of having had a psychosocial evaluation.
The only medical weight management program that they'll cover is Weight Watchers. To get into that, I have to make an appointment with my doctor's office, go in, and have a special form filled out that I also have to sign saying that I'm committing to the program. Then:
- They'll review the form and if approved will send me a welcome packet that will tell me where and when the meetings are.
- I have to attend at least 10 meetings in a 12 week session.
- At the end of the 12 week session, I have to fax in a copy of my progress sheet and the weight loss record.
- If I've lost at least 5% of my body weight during that time and they approve it, I can then do another 12 week session.
If I go through both 12 week sessions, that will count as the 6 months in a weight management program. At that point, I could go to the hospital program which would cover the other criteria. I don't know that I want to have surgery and I know that it's not an immediate cure all. I'm actually glad that there are hoops that must be jumped through.
For now, I'm going to enjoy the last few weeks of summer with the boys and continue to work on the little changes like water intake and trying to make sure that I'm in bed and asleep by a certain time. I'm also considering making a medication change. As some of you know, I've been off my anti-depressants for about two years now. I'm very seriously considering going back on them for a set amount of time so that I can determine whether or not they help me. It's a decision that I'm putting a lot of thought into.
I could keep writing but it's about time for me to get around and take my oldest son to work. If anyone has any information about the current Weight Watchers program, I would love to hear about it.
Until next time...
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