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

Scared To Get My Hopes Up.



Recommended Posts

Anyone else go through this? I've tried to have WLS before and was denied by insurance both times. Always had a BMI over 40 but was told no... had medical records from when I was 11 years old to the date I applied showing my weight and weight loss attempts (I'm only 32 now).... yet they always found some loophole.

I'm with UHC now for my insurance. Like a dummy I picked the high deductible at the first of the year (the thought never crossed my mind to try again after being denied so many times in the past)... so I'm out of pocket at least 1,900.00 before surgery. I'm trying to get all labs, EKG, Chest Xray, UA, and EGD done at the hospital I work for so they're covered 100% (procedure anyway, not the doctor's fee) to cut down on out of pocket. I know a few people I work with who've had some form of WLS performed... so apparently they WILL approve it... I've called the reps a couple of times and have gone over the requirements thoroughly... and I'm meeting them now... just really really really scared to get my hopes up just to get punched in the gut again. Anyone else feel like that? How'd you get over it? Did you wait until your surgery date to let anyone know what you were trying to do? .... sucks.

Share this post


Link to post
Share on other sites

What about going through your HR office for help?

Share this post


Link to post
Share on other sites

I work for an insurance company- I would suggest you speak with an HR person. Perhaps they can make contact with the UHC account manager and find out what exactly is missing from thier precert review.

Share this post


Link to post
Share on other sites

On another note, yes- like I said I work for an insurance company and I am still nervous to get my hopes up. Def understand where you're coming from on that point.

Share this post


Link to post
Share on other sites

I haven't submitted to them yet. I have in the past with other companies.. I'm still going through all of the hurdles right now.

Share this post


Link to post
Share on other sites

I have UHC. Was approved the first time. I was determined to have surgery so I told a select few once I started the process. I didn't even have a surgery date until 3 weeks prior to surgery! Started process in Oct and had surgery in Apr. don't be scared. If you have additional questions feel free to message me. Good luck in your journey :)

Share this post


Link to post
Share on other sites

This is exactly want I'm scared of (a loophole for denial). My surgeon's office is requiring me to pay my deductible, out of pocket cost, $675 program fee, and 20% before they even submit to insurance for approval or denial. All this is non-refundable so that makes even more nervous about this insurance thing. I meet all the requirements of the insurance company but still have the fear that they will find something to deny me on. The only person that knows I'm considering this is my husband and I don't plan on telling anyone else.

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 changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 0 replies
      1. This update has no replies.
    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 0 replies
      1. This update has no replies.
    • KeeWee

      It's been 10 long years! Here is my VSG weight loss surgiversary update..
      https://www.ae1bmerchme.com/post/10-year-surgiversary-update-for-2024 
      · 0 replies
      1. This update has no replies.
  • 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

    ×