Question:
Has anyone been turned down by the insurance company?
My problem is that I don't think my insurance company will approve me because I haven't tried many solutions to trying to solve my obesity under a Dr.'s care. Don't get me wrong I have tried every gimic, just not under the care of a Dr. I am only 21 years old and I basically went to the Dr. when I was younger when my parents told me it was an emergency. If the Dr. brought it to their attention that I was overweight they ignored it. I just recently have seen a Dr. for my obesity. Has anyone had this problem and been accepted by the insurance company anyway? — hbarton (posted on June 20, 2001)
June 19, 2001
I never went to the doctor for diet pills or programs but I was at the
doctor for so many other things and my weight often came up. I tried every
diet known on my own and when I was trying to get approved for surgery I
listed every diet I have been on. Even though I was never prescibed
medicine or on a doctor supervised diet my insurance still approved the
surgery. I wish you the best.
— Sherri M.
June 19, 2001
I would contact your insurance company and ask what the requirements are
for the surgery. If you do not meet them at this time, start now and what
they need. All insurance is different. You should post your insurance
type and try to get responses on individuals with the same insurance. I
did and it helped me to win my approval at the appeals level! Good luck
and don't get discouraged.
— S S.
June 20, 2001
I wouldn't worry about it too much. It does somewhat depend on your
insurance company. I just sat down and made a list of every diet I went
on, the approx time I was on it, how much I lost, and then how much I
gained back. I called my doctor's office and asked them to give me my
weight history and listed that. It showed a progressive weight gain over
the last five years. I had no medically supervised diets as all. I don't
know about what kind of comorbidities you have, but things like high blood
pressure prevented me from using most of the commercially available weight
loss drugs.
— [Deactivated Member]
June 20, 2001
Hi Heather, I also have BCBS PPO and I was denied for that very reason. The
ins co needed to have proof of medically supervised diets. I have tried too
many diets to mention, but very few medically supervised ones. Even if it's
one and you don't think it's significant, go ahead and have your PCP submit
it anyway. If you have any comorbidities, I would suggest that you have the
relevant doctors submit letters on your behalf to recommend the surgery. I
think that is what did it for me even more than the MSD proof from my PCP,
because I was denied again even with that proof. Although they never
admitted that it was a 2nd denial, my request ended up at the highest level
of review it could go.
— dandjon
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