Question:
Has anyone got around the waiting period for a new policy

I have already had my LOMN submitted to the inurance company and have been waiting for an answer. I called today and the rep told me that it looks like I may have to wait until next February since I have a new policy and they can't pre-approve any elective surgeries for 12 months. Is their ANY way around this. It would ABSOLUTELY kill me if I have to wait until next year. PLEASE HELP!!!!!!!!!!    — mikawill (posted on April 24, 2002)

April 24, 2002
You must convince them that WLS is not "elective." It is medically necessary yesterday!! If you have a lot of comorbidities and are morbidly obese, waiting another year could damage your health.
   — Terissa R.

April 24, 2002
they told my sister the same thing.. but if you had insurance, before this company you can call and get a certificate of covergae and they will waive the waiting period..and WLS is not elective..is your Dr.s office talking with the insurance company?
   — charrise R.

April 24, 2002
If you had health insurance for 18 months prior to this new policy, I do not believe they can do this. You should have been provided a HIPPA letter from you previous insurer, you may need to provide this to your new insurance company. If you do not have this letter, request one now, because it sounds to me that your new ins company is doing whatever they can to get out of it.
   — RebeccaP

April 24, 2002
Hello Ladies, Thanks for your help but unfortunately I haven't had continous coverage. I had insurance up until January of 2001 when my husband lost his job. We were unable to afford any insurance after that. He got a new job but it was too expensive thru his job or mine. I eventually just had to go in search of an individual policy which I received in February of this year. After two weeks of my LOMN being in review, someone told me about the pre-existing thing today. r4fw2aShe said that she didn't know if that was the final verdict since it was still with the last person who reviews it, but that is what notes were on my file.I will find out the final verdict tomorrow I suppose.I guess ther won't be anything I can do if they don't remove the waiting period.
   — mikawill

April 24, 2002
Unfortunately if you didn't have insurance coverage, the 12 months may apply to you unless it is considered as medically urgent. This would depend on your health problems, etc. I wouldn't give up until you have exhausted all of your options, but the reality is, you may have to wait for the 12 months. But a little advice in case that is the case. You have been obese your whole life, and if you have to wait until 12 months to get this, then it is worth it. I had to fight with insurance and it was almost 13 months from the time I started until I had surgery. I know, it may be hard to be patient, I wasn't, but it was worth the wait.
   — Dell H.

April 24, 2002
Dell, Thanks for your response and your right. If it turns out that I have to wait then that's what Im going to have to do. I'll pray that a miracle happens but if not, I'll just have to be patient a little more. Thanks again.
   — mikawill

April 24, 2002
I FEEL YOUR PAIN I WAS IN THE SAME BOAT ONLY I DIDNT HAVE ANY INSURANCE PRIOR MY INSURANCE BECAME EFFECTIVE 4/1/02 AND PEOPLE KEPT TELLING ME THE SAME THING WELL LET ME TELL YOU I PRAYED AND I CRYIED ( THE PRAYER HELPED NOT THE CRYING LOL) ANY WAY WEIGHT FOR LIFE SENT IN MY PAPER WORK ON 4/05/02 AND ON 4/17/02 I WAS APPROVED!!! AND MY SURGERY DATE IS 5/14/02 I WAS VERY LUCKY CHECK TO SEE IF YOUR STATE HAS PASSED ANY LAWS CONCERNIG WLS AND CHECK YOUR JOB`S INSURANCE PLOICY TO SEE WHAT THEY SAY ABOUT WLS BECAUSE IF YOUR JOB COVERS IT AND IF YOUR STATE HAS LAWS IN PLACE STAING THAT AS LONG AS YOU MEET THE NIH CRITERIA YOU SHOULD HAVE NO PROBLEM AND MY JOB`S INSURANCE IS BC/BS CAREFIRST PPO I WISH YOU THE BEST OF LUCK.
   — rochele1970

April 25, 2002
Rochelle, Thanks for your response. I just checked again with the insurance company and they still say the same thing, that my contract has this 12 month waiting period. I am just really depressed right now. I know Georgia has passed that law you are talking about. I just don't know what to do. I don't know if I can try to appeal or if it would even make a difference. Since they are not actually denying the surgery persay, just finding another way around it with this waiting period thing. Uuuuggghh - I am so frustrated.
   — mikawill

Click Here to Return