Kind of Devastated - Denied DS Surgery
My whole world has just turned upside down! My insurer has denied me for the DS because my BMI is not above 50 (I'm about 43 BMI).
I did not anticipate this - if anything I anticipated them denying me period. Originally my choice was the sleeve but because of knee surgery I thought the DS would be a better match for me especially because I could eat normally. Now, I don't know what to do. They will approve the Sleeve or Gastric Bypass. I guess I will get the sleeve. At least that is the first step of the DS and if I don't achieve much weight loss maybe they will approve the second part of the DS
Again, I'm devastated because over the last 3 months all I have done is research on the DS and was really hyped about the great results folks were getting. I'm thinking my results wont be the same..................HELP!!!!!!!
This happened to someone just recently, so I hope they will chime in.
I know that they reviewed the policy themselves and there was no stipulation about BMI requirements for DS, so they could not dictate that the BMI wasn't high enough, and they got the denial overturned. I know that others got their surgeon involved in an appeal to help with why the DS would be a better option (ability to take NSAIDS for your knee, for example, better Diabetes resolution results.) and got success there, too.
There is room on this earth for all of God's creatures..
next to the mashed potatoes
Just keep fighting to get it. If you give up, the insurance company has won. It took me years to get mine done. It took changing employers to get it done. MY insurance would cover it, but my employer put restrictions on gastric bypass. Anyway, keep plugging away at them until you get the answer you need.