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Denied by insurance!!!

Hello everyone...

 

Well I was recently denied by my insurance for the surgery and unfortunatly I can't afford to pay for it myself. I so desperately need it the last time I weighed myself I am at 350+. If anyone knows of a way I can get it done some how. If you can be of any help PLEASE let me know. I am only 33 yrs old and don't want to go on like this. I have tried everything in the book to lose the weight and can't.

I have already looked into state insurance but as I have insurance I don't qualify. Anyone out there have any problems like this? What did you do? And yes it is an EXCLUSION in my insurance policy.

 

PLEASE HELP!!!

6 Comments

Recommended Comments

divaga75

LAP-BAND Patients

Hello everyone...

Well I was recently denied by my insurance for the surgery and unfortunatly I can't afford to pay for it myself. I so desperately need it the last time I weighed myself I am at 350+. If anyone knows of a way I can get it done some how. If you can be of any help PLEASE let me know. I am only 33 yrs old and don't want to go on like this. I have tried everything in the book to lose the weight and can't.

I have already looked into state insurance but as I have insurance I don't qualify. Anyone out there have any problems like this? What did you do? And yes it is an EXCLUSION in my insurance policy.

PLEASE HELP!!!

ParrotheadCathy

LAP-BAND Patients

My insurance had an exclusion too. I obtained financing. $10,000 (I paid $5,000 up front) is running me $187 a month. My justification was this: I was taking 8 prescriptions a month (I still take one of them, which is to help me sleep more than 4 hours a night). 3 of them had $35 a month co-pays and 4 of them had $25 a month co-pays. That adds up to $205, which is an $18 a month savings to me. I also was eating lunch out every day at +/- $8.50 per day on the average and now I take my lunch for a fraction of that but I didn't even take that into consideration. Unfortunately, that is about all I can offer. I understand how you must be feeling right now because I felt pretty badly when I realized my insurance wouldn't touch this.

One thing I did do. You have to have some pre-surgery testing. I talked to my primary doctor and he gladly made all the referrals for me to doctors that were on my insurance. They reported to him and he sent everything to the surgeon's office. That way, I didn't have a ton of expenses up front, just a very few co-pays. He sent my blood work in himself as part of an office visit.

I got my financing through Care Credit. Capital One also does medical financing.

Wish I could offer you something better.

Cathy

psalms

LAP-BAND Patients

I know several people who were denied but filed an appeal and won. Keep on moving forward don't give up. This is your life and you have to fight for it.

itismk

LAP-BAND Patients

I was denied by my insurance initially. Be persistent...it pays off. It took me a year of talking back and forth with my insurance company - I called every doctor I'd ever been to in order to determine my heaviest weight. I bugged everyone because I knew this was what was best for my health.

I had a sleep study and was diagnosed with sleep apnea, which I think helped my chances of being approved. I told my contact at the insurance company I would appeal the decision if it was denied again because I knew this was the right tool for me to finally lose the weight.

I had my surgery April 27th and do not regret it one bit.

Good Luck - I wish you well - I know how difficult it is emotionally to hear that you've been denied.

MK

Lisa07

LAP-BAND Patients

Sorry to hear you were denied, that really stinks, I would also appeal. I had my hopes up and now I'm deflated! I have Care First Blue Cross. I was just told I have to follow 2 three month diet structured programs as one of the criteria for having the surgery, d0 other insurances make you do that? Haven't most of us already tried Weight Watcher several time (just not with the two year timeframe they want) and I did Nutrisystem for 4 months last year. Sorry, don't mean to whine but insurance makes everything so darn hard! I wouldn't have any other problem meeting the criteria..... I'm really bummed!

Angie65

Gastric Sleeve Patients

I am self pay. My spouse's insurance has a written exclusion. Anthem approved me but, my spouse's company who is self funded denied me with no appeal on exclusions!:) I canceled cable TV ($78.00), newspaper ($20.00), and home phone ($55.00). I brown bag my lunch and make my coffee at home. I was devastated when Anthem told me that my pre-approval was worthless. It has taken me three years. I hope you find a way because, you are worth it.

Just hang in there:thumbup:

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