Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Devastated!



Recommended Posts

I have done my seminair my 18 mo supervised diet and all the other hoops. My insurance I called 5 times to verify coverage and read it in my handbook. I had my pre op with the dr and they told me they were sending stuff in that day and that was the 14th I think. I called my insurance a week later they didnt have I called Dr they said oh we are sending it today. I called a week later again insurance didnt have it. SO I called the Dr they said we sent it today-- I was getting a little frustrated but I thought "just be patient" So I called yesterday to find out if I am approved and they said I am denied that dh work put an exclusion on it as of NOV 1 they day they received my paper work!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I am going to appeal but I know it wont do any good I dont know who to be mad at the DR office or my dh work! I was so helpful that this was the tool to help me get healthy and be around to raise my kids-- I cant believe I was one day too late!!!!!!!!!! Anyone else have approval even though their was exclusions. I had 4 dr's write in saying I need this surgery. I think I will start a web site for self pays and we will all send 5 people $5. for the surg-- like a pyramid scam! Coarse you would have to have 3000 people do it for 5 people to get the surgery!!! Any ideas-- I tried everything and I cant loose weight! Jill

PS I know I saw an appeal letter on some web site it was very good any idea where it is?? Jill

Share this post


Link to post
Share on other sites

I would go straight to your husband's work and talk to HR. Explain the situation to them. Because you were already preparing for the surgery they may allow insurance to cover it. I think you have an excellent case for an appeal with the insurance company - don't give up now!

Share this post


Link to post
Share on other sites

Oh boy that does suck. I agree with Anne, go to hubby's HR dept and start there. Uhhh i could scream for you. I'm very sorry.

Hugs, Eileen

Share this post


Link to post
Share on other sites

The problems with insurance are the "suckiest" part of getting this surgery done. We just have to hang in there and be strong. Either wait for our insurance to cover it, as I'm doing with Medicare, or get up and fight those that have an exclusion. I laugh at the ones that will say OK to gastric bypass but no to the lapband. Do they even realize how dangerous one is as compared to the other. I say if you want this keep on fighting to change what is unfair. It burns me up. I too went through a lot of preparation, but now if Medicare covers it in Jan. I have all of my work behind me. The sleep apnea test which was positive is done and I'll be going on C-pap tomorrow; I'm having my psych eval in Dec. and I have an EKG and electrocardiogram, plus letters from my cardiologist and my dr., plus a dietician's letter. I'm anxious to see what other roadblocks they can throw in my way.

The only thing I can say is that if half of these women here had taken NO for an answer none of them would be banded today. The road is long and hard and takes perseverence. Good luck.

Share this post


Link to post
Share on other sites

I too think you have an excellent case for an appeal, stay positive!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Losing my hair in clumps and still dealing with "stomach" issues from gallbladder removal surgery. On the positive side I'm doing better about meeting protein and water goals and taking my vitamins, so yay? 🤷‍♀️
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      · 1 reply
      1. BabySpoons

        Amazing! Congrats!!! Watch out for the sharks. 🦈

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×