Lap Band Surgery Insurance Denial

[loveleelovableness 0]

Today I recieved a letter of denial from my insurance company I went through the entire pre-op and I had all the qualifications; BMI more than 40, medical problems etc. I am so sad and upset at the same time. I was afraid this was going to happen.

[Doriehi 3]

Don't give up.

[Doriehi 3]

Don't give up.

[2bSMALLER 28]

I was denied also ... We appealed ASAP and I was finlly approved .

5'9 236lbs. BMI 35 Mild sleep apnea.

I just got my lap band December 1,2011

DONT GIVE UP !!!

What insurance do you have?

[loveleelovableness 0]

@2bsmaller I spoke to my consultant and she advised me to get a benefit summary from my insurance company ASAP. She said they will start the appeal process immediately. I am so upset... I don't understand why they are so quick to deny this procedure when it has benefited so many people. I have United Health Care.

@Doriehi thank you!

[loveleelovableness 0]

I was also diagnosed with sleep apnea...

[2bSMALLER 28]

I was denied after like 4 days the first time.

But when we appealed, it took about 21 days for them to approve me.

Just find out what YOUR insurance requirements are .and make sure u met them all .

[GB2011 5]

Wow, that's terrible. UHC is usually one of the better insurances when it comes to bariatric surgeries. Keep trying and don't give up. I went through the entire process in 2006 only to change jobs (where they had United Health care insurance), only to get to my orientation to find out they had switched insurance to some local mess that did not cover weight loss surgeries. I just got my surgery done in May. If you want it, keep pushing for it. Good luck to you!!!!

[loveleelovableness 0]

The only explaination they gave was simply that they don't cover it. I will not give up. This is horrible. Thanks for the replies everyone!

[ready4changein2011 70]

Sorry to hear you were denied, is it because they don't cover wls through your job. That may be the reason although we have insurance sometimes through our employers they elect to not cover the procedure. I have UHC also, now I'm concerned, but the clinic I attend did verify that its covered through my insurance and I also called. They say as long as I use my companys hospital it will be covered. Don't give up, keep fighting but if it isn't covered I've heard on here on this site that its a lost cause. So get your benefit summary, it will tell you or try UHC online it will tell you there also. Wishing you luck.

[Violet953 46]

Ugh that really sux I'm so sorry! Did you appeal it yet? I hate how they make you go through all that just to find out you are denied.....why can't you find out beforehand?? Its just not right to waste your time like that...and if you really aren't covered, maybe you could try to get medicaid...that's what I have and they cover it no problem.

[Brit7 2]

Don't give up. BC denied me twice and only authorized surgery after being contacted by a lawyer. Authorization was granted 12/23 but, too late for me to request time from work. Insurance companies are crafty...So, a new year and surprise to me my employer signed with a new insurance- Blue Shield. Another auth. request...and happily BS authorized first time.

About the lawer, my surgeon referred me to a lawer hired through Allergen (makers of the Lap band). This may be an option for you. I can certainly give you their contact number....

Good luck and dont give up, that 's exactly what the insurance companies want you to do.

Brit7

[PWoo10 7]

Sorry but if if your insurance doesn't cover it then it isn't covered. Didn't your doctor office checked your insurance requirements and if it was covered before they started this? There are employers having WLS takin out of the policys.