goula_gal

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My request for pre-approval was denied due to a specifc exclusion regarding wls. This is SO frustrating because not only did I call after the first of the year to see if I had coverage, I got an email from the insurance company stating the requirements to meet before submitting the paperwork for approval.  After the denial I sent a copy of the  email showing them where they listed the requirements.  I was told the customer service rep had made a mistake and the terms of my policy ruled.  When I talked to the financial rep at the doctor's office she told me there was nothing else we could do. At this point I'm going to start researching Mexico surgeons and see what will be going on with my insurance next year ( there are rumors of a change again next year). Then the beginning of next year I will either go to a surgeon in the US if I have insurance or go to Mexico if I have to self pay.

I had to have a copy of my medical records sent to the surgeon, a letter of recommendation from my PCP, a psych evaluation, a three month doctor supervised weight loss program, and two consultation with the surgeon, before submitting my insurance paperwork. The paper work was faxed to the insurance company on June 16, 2010.  Now I wait for their response.

In November shortly after attending the wls seminar I found out our insurance would be changing at the beginning of the year.  I decided to wait until after I received the new insurance paperwork and found out the new requirements before moving forward.

I attended a weight loss surgery seminar in October, 2009.  I thought (silly me!) that I might could have surgery before year end.  Little did I know of the requirements of the insurance company....