mizzymizan
I am37 years old and have been over weight all my life. I was always health even being big until about 3 years ago. I am single and i have never been married. All my friends are between sizes 4 to 10. I have had a friend as big as i or bigger. So i have had to deal with them always getting the attention and the dates and the gifts and trips and marriage proposals. I am the second out of 3 kids. Two girls and a boy. My sister was always a size 4 until she got married and her husband wanted her to gain weight so she did. Which she is struggling to lose. It wasn't until my health started to fail that this was something i started to look into since in 2006 i went to my mothers pcp and on my first visit i was told that i needed to have WLS i was so upset and in shock that this women would tell me this. My thought was was i that big and disgusting for her to tell me that. I was not looking at it as i was unhealthly. So i started to research this and get all the info i could.
I needed a second opinion and was told the samething. Humanna told the surgeons office that this was a covered benefit covered at 100 percent. After taking all the test and when the paperwork was submitted the insurance company then said it was an exculsion. Vista exculsion. My insurance company needed a letter from my pcp so i asked my pcp she said fine no problem however the catch was i had to go see her to get the letter. Well she spoke to me for about 5 minutes and then tells me i will receive the letter in the mail. I was looking like why did you have me to come all the way down there plus being late to work for nothing. I soon found out when i got the bill she billed my insurance 285.00 for a diagnostic.
I found a new Dr. At the first visit he too said i needed the surgery. I told him that UHC won't pay for it he said not to worry i will fight for u. He did he fought and fought he spoke with medical directors he appealed everything the last medical director he spoke to said that if i have a stroke or heart attack then they will reveiw again. United Health Care denied exculsion only because i was a employee.
2009 i have aetna that orginally denied for not having all my 6 months and told me that i needed to appeal because i missed the 14 days for reconsideration. After pointing out to them that there was a lack of communication on there part. They reviewed my file with the full 6 months yesterday and called me today and told me that i was approved.
