Unsure what to do...

kendria79
on 5/29/12 1:51 pm

Hi everyone,
I spoke to BCBS and they said I have to be employed with the state for 5 years in order to have the surgery. I have only been there for 2 years. I guess I have to start saving my money... This really sucks because every where I have looked is $13,000 and up.

Thicklin
on 5/29/12 10:39 pm - TN
VSG on 04/23/12

Sorry that's sucks! but have you thought about going out of the country. Might be cheaper and somewhat a adventure too.

            
angenoire
on 5/31/12 12:31 pm - NJ
RNY on 05/03/12
Hi.  Sorry to hear about that.  I wonder if you can appeal that decision or even ask if they have that done in writing anywhere.  Especially since you have health reasons to have the surgery done. 

Best of luck to you. 
Taking it one day at a time.    
MSW will not settle
on 6/2/12 6:05 am
This may not be legal given wls is covered and may be medically.  I suggest you appeal with the insurance company first.  If this is unsessesful, contact your state's department of insurance and challenge the 5 year provision. 

I have had success with this apprach more than once.  Each time I was denied a medically necessary procedure for bull**** reasons.  Bottom line, it was expensive and they were hoping I would just go away quietly.  Each time the insurance company backed down before the state made a ruling. 

Also check out the insurance forum on oh.  At one time there were a few very knowledgable participants.  However, in my less than humble opinion, general site administration bull**** has driven the best of them off of these boards.  The oh search feature does not fuction well if you need to focus on a specific issue.  But with patience, you can review threads prior to mid 2009 and work backwards.  You may find the threads with approaches others have used succesfully. 

Another resort is financing.   There are companies that finance medical procedures both here and abroard. 

Best of luck to you.  I hope you find that loophole that results in a fair deciaion. 

                   MSW   Roux-En-Y Gastric Bypass: Eat sensibly & enjoy moderation  

 Links:  Are you a compulsive eater?  for help OA meets on-line Keep Coming Back, One Day At a Time  Overeaters Anonymous 

               LV'N MY RNY.  WORKING FOR ME BECAUSE I WORK FOR IT. 

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