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Many employers are no longer covering weight loss surgery or have a once in a lifetime limit. Insurance companies are tough to work with. I get approval letters that will say the procedure is covered but there is go guarantee of payment.
I guess that means that they agree I need the procedure but they might not pay for it. It is really strange.
Good luck on finding a way to get the surgery. There is a law firm that specializes in cases like this. Give them a call.
Lindstom Obesity Advocacy
Real life begins where your comfort zone ends
I'm always so sorry to see this type of post. When an insurance company agrees to any procedure here at our house, we get them to send us that answer on their company letterhead. It's saved us a few times over. We had to learn it the hard way.
But most people don't think of that and especially if they've never been in a situation such as yours. You might want to start doing that from here on out, although I know it won't help you right now.
When you actually read your policy through for yourself, what does it say? If it doesn't flat out decline to cover bariatric surgery you may have an opening. Especially if they approve on a case by case basis. You've got lots of documentation (I'm hoping) that would support an appeal.
If that avenue is completely closed there are still other options. Some places finance medical procedures. There is one called Care Credit and perhaps that could be an opportunity? Other folks dip into their retirement/401k because they decide that this surgery IS really that important. There is also Mexico, etc. and if you haven't had a chance already you may want to look into that.
Knowing there is no magic answer makes it difficult to encourage, but you may find something while you're looking through your last options. Good luck to you. Keep trying until there aren't any options left. At least you'll know you've done every last thing that you could.
Also, this link has lots of ideas on how to reduce the cost of surgery:
https://www.bariatric-surgery-source.com/cost-bariatric-surgery.html
Have you spoken to the insurance coordinator in your surgeon's office? They may be able to help.
My Surgery is set for Monday Dec. 9, 2019. Monday I got a phone call from my insurance's approval team saying that they were denying my surgery coverage due to a provision in my employers insurance policy. The coordinator at my doctors office had spoken to the insurance customer care team back in May when I started this entire process and they told her I was covered. When she called again on Monday they told her I was again covered but the approval team said I'm not. Both I and the Benefits coordinator called several times They said my only options was an expedited grievance, which I wrote out and submitted on Tuesday, I was told the the decision would be made by today and guess what? I was denied.
I feel so discouraged. I don't have Monday to pay for it, I spent so much time and effort, was on the liquid diet. Since before thanksgiving.
I feel lost and upset.
on 12/4/19 12:43 pm
This topic worries me, I'm not sleeved yet. I have the absolute worst pains during my cycle. Sometimes they make me vomit they are so bad. Like 8/10 on the pain scale. The pharmacist I met with gave me a list of medications/vitamins I can take and different types of deliveries that would be preferable, liquid, sublingual, etc. But she did say no nsaids and to take tylenol instead I didn't press the issue. I thought "oh, maybe when I lose weight my periods will be lighter again". (not sure why I thought that.) Tylenol NEVER cuts the pain. Heating pad does help with some of the pain but not all of it and I can't lie in bed with a heating pad all day. If anyone finds a medication that helps, let us know! I'm going to ask the surgeon when I see him if there is another way to take an nsaid, rectally or injectable or something. will update.
You can use them, digestive enzymes, but some people really like the probiotics. That can help with digestion and other things.
For some people, even a relatively small amount of Sugar Alcohols (SA) can cause issues with toxic gas. Getting constipated can most likely cause more gas, since the "food" stays in for a longer time.
Some fruits are worse than others to cause gas. And starchy carbs.
As for fiber - for me personally fiber can give me wicket gas, pain, and cause getting more constipated. If I even eat anything starchy, lower fiber products are less likely to cause gas.
I.e. banana vs apple or pears. Apple and pears have a lot of pectins that can feed our internal bacteria causing gas.
As WD mentioned, I also get bad reaction from using BA chewable vitamins. Now I take a pill, or use some taht don't have any SA. Sugar or fructose is better for me and my personal relationship than any SA.
Hala. RNY 5/14/2008; Happy At Goal =HAG
"I can eat or do anything I want to - as long as I am willing to deal with the consequences"
"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."
Chewing a piece of gum or taking a multivitamin or prescribed medication containing sugar alcohols is unlikely to cause you digestive problems.
She and others like her. I can't chew the SF gums or take any chewable vitamins with SA. Even that small amount (3-4 grams) is enough. BTW: as a perspective - 1 tsp of sugar is 4 gr. So 3-4 gr of SA is actually almost a tsp.
Hala. RNY 5/14/2008; Happy At Goal =HAG
"I can eat or do anything I want to - as long as I am willing to deal with the consequences"
"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."
