Insurance problems

chiefsgirl3
on 4/17/12 3:29 pm - IL
VSG on 06/05/12
 So my jnsurance company is saying that although my starting bmi was 37.4 and I have 3 comorbidities that my comorbidities are controlled by medications and therefore I do not qualify. So mu doc is going to do a peer to peer review but if that doesn't work i have a choice to make. Gain 30 lbs to reach a bmi of 40 or no?  Is it worth it?  Would I regret it at all??  Any thoughts??
        
bigmama3
on 4/17/12 11:06 pm

My insurance company didn't approve my surgery either (in the beginning).  Although I had a bmi of 40, they said I didn't have for 2 years. 

My doctor did a peer-to-peer and they didn't approve (he was so mad).  I went through 2 appeals and finally went for an outside appeal to New York State--won and had the sleeve (finally) 51 weeks to the day I first went to the surgeon.

Keep appealing--you can win.  Also, the insurance carrier may have criteria, similar to mine, that you must be 40 bmi for a certain length of time.

    

CW - 125 (20 lbs. below goal)

chiefsgirl3
on 4/17/12 11:08 pm - IL
VSG on 06/05/12
 Thanks!!  I will look into that!
        
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