UGH DENIED !!!

Dr could still be wrong. He might be right, but I like to check things for myself. I don't think it's different state to state but insurance to insurance.

My surgeon's office submitted the paperwork. Some came from my pcp and some from my sleep doc. ( I was diagnosed with apnea long before I looked into surgery)

Call your insurance company and have them send you a link for criteria and also for the appeals process.

I'm sorry you got denied. I know it's tough right now. Hoping things get better for you.

I am in NY and my sister is trying for LapBand. Her problem is that her BMI is very Close to the guidelines & if she doesn't keep her weight betw 200-210; they could DENY her. She's done great on the pre-weight loss requirements and continues to lose; she may end up not doing the surgery because of that. I am about 200 lbs overweight and my BMI is such & my medical things that I will be approved (or so that's what the doc says). I wish you the best. Why would they talk you OUT of the LapBand, if you would have been covered under that, it's like they are dangle your salvation in front of you and then ripping it away! Sorry.

I would start with your insurance policy. Get a copy and see what they require. If you get that info and feel like you should be covered. FIGHT for yourself. Insurance does not want to pay for these surgeries if they don't have to. I have a high BMI with 2 co/morbid and they still denied me 1st time. Don't give up.. I know how devastating it is to hear those words

Autumn, I would check around for other doctors in your area and see what their requirements are.  Also, like the other posters said,  talk to your insurance company and see if it is a covered benefit and what are the pre-requirements for it. I would also rec getting it in writing just for your records too.  I am sched for Sept, but with my BMI and other issues, hopefully my approval will be smooth.  I was just lucky that my doctors and my insurance companies' requirements were exactly the same.... Don't give up ....... You are worth it !! 

Also keep in mind, usually once you are denied you have the right to appeal ( thats how I got my surgery, but with the help from my surgeon) but that denial is active for 1 year, which means you have to wait another year from the date of the denial to re apply for the surgery

 I never would have believed I had sleep apnea but yep I do! S get the study done and pray you have it LOL good luck!