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I've not had that issue but as someone who used to work at a health insurance call center, I've seen things like this work out for people by arguing that you went to a contracted WLS doctor and that you did NOT choose the clinician for the psyche evaluation and therefore THEY should cover it. I would recommend that if they do not want to cover it to inform them you would like to appeal and ask whether they have an appeal process if so go through that, if NOT or you have exhausted the health insurance companies appeal process then you have a right to appeal to your states Dept. of Insurance.
I got an approval letter from iehp to see a surgeon yesterday. :)
I received information from my insurance today and they require a 12 month continuous medically supervised weight loss programs. I've seen 3, 6, and even 9 month requirements but 12 months?! Anyone else encounter this and how did you deal with this situation?
some ppl have met the 12 month req. by having seen their doctor regularly when diet and exercise was discussed.
The ppl who haven't had the dr visits,just had to start with month one and do it for a year to qualify.
there is also self pay,if you are able.
I received information from my insurance today and they require a 12 month continuous medically supervised weight loss programs. I've seen 3, 6, and even 9 month requirements but 12 months?! Anyone else encounter this and how did you deal with this situation?
So, I have been on the fence for about 10 years and I seem to only continue to be yo-yo-ing and I want to be here for my son, its just us... However, things have changed drastically financially. So I find myself on Medicaid in NC. I went to REX's info Session at the end of 2014 and at that time they were saying that they accept Medicaid. Went to my appointment a month ago only to be told that they do not!
So I registered for an info session with WakeMed; only to find out the same thing.
Is there anyone that has been able to use Medicaid here in Wake County or near? I am desperate and this was my goal for 2015... I'm not giving up, but I was hoping maybe someone here may know something or have used the plan.
Ann
Ruth did I read this correctly tricare paid for your revision???? Can you contact me by email [email protected]
thanks
Dot
Was going through the final steps leading up to my surgery day, all of a sudden my doctor that I been seeing decided to retire, and can't do the surgery before his final day. Now it look like it will be a while before I get a surgery date.
Also my insurance is expiring in a few days, and COBRA is to expensive. Did anyone purchase their own insurance policy to have the surgery? or use the Affordable care act (Healthcare)? any suggestions.
I'm still working on it. Iehp required me to go back to my primary care for 6 months and they just resubmitted a referral Friday I asked them to send over also a letter of medical necessity and copies of my weight from my charts going back to age 7 when I became obese. I'm also on cpap therapy as of April with newly diagnosed severe sleep apnea so we'll see what happens.
Im right there with you..i hust got my denial letter as well..im working on my appeal letter..unfoetunately although ive been obese all my life there isn't enough re ords to proove it..im trying to send as much information as i can..
were you able to get surgery?
Hockeymom87 · 0 replies · 857 views
