Debi D.
Surgery Date: November 29th, 2004!
I am a 42 year old Wife, and Mother of 2, a daughter 23 and a son 10. I am also a Grandma to a very special little guy named Hunter Logan who is 2! I have struggled with my weight all of my adult life, especially after my first child. Than 13 yrs later we discover we are having another baby, my husband is ecstatic and I am scared, as I don't want to gain any more weight because I'm already heavier than I ever wanted to be. But I had a wonderful pregnancy and actually lost weight, and my son gave off something that put my arthritis in remission that continued several months after his birth and once it returned it was less severe. My journey actually started on May 19th, 2003, with Aetna my husbands insurance through his plant, which closed down after 27yrs of service with a one yr severance, and one yr insurance pre-paid for out of that severance. We only had a few months left but I was hoping to get it approved as I had already met my deductible and was wanting to save some out of pocket, but that was not to be. I waited for months with no word from my insurance whether I had been approved or denied or that I needed to send more information. And I have to say I feel my surgeon�s office let me down by not following up on this or helping out in any way with my insurance company. This of course was before I was told about this site and knew that I could call and pester my insurance company and my dr.'s office. I want to thank my husbands cousin Connie for telling me about this site it has been detrimental in my decision to keep fighting for what I want and making me feel it could happen to me. After waiting months for Aetna with no response I finally had to call my Dr.'s office and tell them that I was on a new insurance and we would have to resubmit to my current insurance and hope they did not find it a pre-existing problem. Anyway I am now keeping in contact with my insurance company and plan holder contact person Arla (whom I found to be quite pleasant) and hope she can get me through my current problem with my insurance company. It seems that my insurer will not cover unless it is found to be "medically necessary" which my surgeon said in so many words but did not use those two very important words. So now I have to wait for him to get back from vacation at the end of the month (today is the 21st of Jan.)To re-submit another letter stating that he finds I'm medically needy for this surgery..UGH..what next?
