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The first step

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tigerlily1977

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I am very scared to take this step to actually see the surgeon. I think my fear comes from being denied the surgery due to insurance reasons. I have been given the referral to see the surgeon. I have great insurance. I meet the criteria for the being at least 100 pounds over weight. However, I don't have any of the other medical issues. I am afraid of that denial from my insurance in the end. The patient advocate tells me that it is based on a case by case decision. Any advice on how to calm my nerves or make my chances any better of hearing a yes. I have tri-care prime.......Has anyone ever been through this process with this insurance??

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I am very scared to take this step to actually see the surgeon. I think my fear comes from being denied the surgery due to insurance reasons. I have been given the referral to see the surgeon. I have great insurance. I meet the criteria for the being at least 100 pounds over weight. However, I don't have any of the other medical issues. I am afraid of that denial from my insurance in the end. The patient advocate tells me that it is based on a case by case decision. Any advice on how to calm my nerves or make my chances any better of hearing a yes. I have tri-care prime.......Has anyone ever been through this process with this insurance??

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i was in the same boat as you. i have a very high BMI but didn't have any other medical issues. i was afraid that my insurance would turn me down too, which they did the first time. my doctor submitted the necessary paperwork to the insurance for my weight history for the past 2 years. it showed that my BMI was below the obese level because i was doing LA Weight Loss. after the first reject letter, i worked with my dr. office to gather more info and we went back 5 yrs of my weight to prove to insurance that i have always been "thick" the whole time. insurance approved that info after that, so i am scheduled for surgery on July 21st. keep plugging away at insurance, don't take NO for an answer!!

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