upset and crying DENIED

shellybellymichele
on 5/6/11 10:05 am - Canton, OH

I have been waiting two weeks to hear if i got approved and then i get a letter in the mail from my insurance company that my request for surgery was denied, do to this surgery has not been proven as an effective weight loss tool. But it does say in the letter that i have the right to appeal. So I will call my dr. on monday and see where we go from here. I am just so upset.

samsander
on 5/6/11 10:08 am - CA

I am sorry!

Lots of people appeal and get approved though, so I wish you luck!!!

Mary SW 273 CW 158 GW 160

(deactivated member)
on 5/6/11 10:11 am - Santa Cruz, CA

RNY on 06/20/05

Whoever sent that statement is a stupid a**. There is more and more medical research stating in big letters that Gastric Bypass (and RNY) is a great weight loss help.

Don't let them get you down.

Hugs,

chrisgraves
on 5/6/11 10:19 am - MA

RNY on 10/26/10

I'm sending HUGS. BIG ONES

!

Keep trying appeal appeal appeal. It sucks I know, I had a similar issue. I wish you the best of luck.

nfarris79
on 5/6/11 10:23 am - Germantown, MD

RNY on 04/13/11

SO sorry that happened to you and APPEAL b/c the insurance people are stupid jerks who have their heads up their butts!!!

First ultra: Stone Mill 50 miler 11/15/14 13:44:38, First Full Marathon: Marine Corps 10/27/13 4:57:11, Half Marathon PR 2:04:43 at Shamrock VA Beach Half-Marathon, 12/2/12 First Half-Marathon 2:32:47, 5K PR Run Under the Lights 5K 27:23 on 11/23/13, 10K PR 52:53 Pike's Peek 10K 4/21/13, (1st timed run) Accumen 8K 51:09 10/14/12.

Bootssie
on 5/6/11 10:38 am - CA

RNY on 12/17/10 with

Does your insurance even cover bariatric surgery under your plan? Some don't, but it's because the company itself excludes it. For years, I never had an insurance plan that covered it. When I started my last job, I had a choice between an HMO and a PPO. The HMO would not cover it. The PPO was a higher premium, but it covered RNY and Lap Band so I chose that plan.

If your plan does not exclude it, I'd be willing to bet you would win an appeal.

SLIMPRGIRL
on 5/6/11 11:24 am

RNY on 12/16/09

My surgery had been denied,, I appealed and it was accepted.. I bet the same will
happen for you! best wishes,,,

shellybellymichele
on 5/6/11 11:36 am - Canton, OH

RNY on 06/28/11

Thank you everbody. You all give me hope. My insurance plan covers it if it is medically nessessary. Which my doctors say it is. I have high blood pressure, type two diabetes, gerd, pcos, double curved scoliosis, and sever sleep apnea. my bmi is 42 which is down from 45 six months ago when i started the medical supervised diet plan that the insurance required. I just hate that I've done everything that they have asked of me Paid out of pocket over two grand for fees that they didn't cover. Because the bariatric care center that i am going to has a program fee that the insurance doesn't cover, and now they tell me that this surgery will not help me. I agree that they have their heads up their butts.

Lady Lithia
on 5/6/11 12:30 pm

A lot of insurance companies routinely deny..... then routinely grant appeals..... they want to weed out all those who aren't totally determined to get the surgery.

There's an insurance forum here..... lots of advice there!

~Lady Lithia~ 200 lbs lost!
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!