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Disappointing Denial

When I had my very first appointment with the surgeon, I told him I was interested in the LAP Band. At that appointment, he told me a little bit about the Vertical Sleeve but it was the first time I ever heard about it.

After going home and doing lots of research, I decided the sleeve would be way better for me. I told this to an office staff member at the surgeon's office.

Then I got a call from the office saying insurance had approved me for the LAP Band. I told them AGAIN that I didn't want the band, I wanted the sleeve. The office girl said, "Oh that's not a big deal to switch from the band to the sleeve."

But a couple weeks later, it turns out the insurance DENIED the sleeve. The doctor's office is appealing it but I am NOT happy. There's no way I afford this surgery without insurance.

I feel so terrible - it's like I had hope for the first time in my life that I could actually lose weight and it was snatched away from me. I don't know what the heck I'm going to do if this appeal is denied.

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  • I go to other countries for medical procedures when they are not covered by insurance in the US. Medical tourism is clearly going to expand due to the increasing costs of healthcare in the US. It is

  • NancyJerry
    NancyJerry

    I hope this works out for you! I would think that you either qualify for "bariatric" surgery or not! I can't believe (....oh but I should...) that the insurance companies are going to get involved t

  • Thanks for the encouragement, everyone. I'll try to keep hope alive but I just don't want to be crushed if this somehow doesn't come through. I'll keep you posted!

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I hope this works out for you! I would think that you either qualify for "bariatric" surgery or not! I can't believe (....oh but I should...) that the insurance companies are going to get involved to the level of telling patients WHICH bariatric surgery to have! Grrrr.

I'll pray for your appeal! And if you get denied again....appeal AGAIN!

GOOD LUCK!

I just went through a simular situation. I was approved for the bypass but that was never discussed in any of my appointments. I was at the mercy of the insurance company and orginally they told me than can take up to 30 days to change the code to a sleeve. I was devasted! Everything worked out, this all happened last week and surgery was already set for the 16th so I know how you feel when you almost got your hand around something that you really want and then it's snatched away from you. Hang in there, you will get your sleeve!

The EXACT same thing happened to me! I did appeal and had my surgery Feb 16th, 2010 - keep on trying!! You can't afford NOT to have this surgery!

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Thanks for the encouragement, everyone. I'll try to keep hope alive but I just don't want to be crushed if this somehow doesn't come through. I'll keep you posted!

Rosie, I don't have insurance and I know that I will never have enough money to pay for the surgery here in the US. I've been doing a lot of research about having the surgery done in Mexico for under $5,000. :)

I go to other countries for medical procedures when they are not covered by insurance in the US. Medical tourism is clearly going to expand due to the increasing costs of healthcare in the US. It is sad that our insurance system works the way it does. We must address it through legislative changes.

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