Insurance problems
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??
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.