I don't have insurance that covers. Has anyone gotten a denial reversed?

Betsyjane · October 20, 2006

Just trying to figure out how to pay for this darned thing. I'm having it done in 2 weeks. Has anyone had an insurance company say they just don't cover bariatric surgery and had it appealed successfully?

Hey, I'm also curious. How the heck do you stay on the pre-op diet???? Seems like if I could do that, I might not need the surgery!

beachgirl · October 21, 2006

I wasn't jumping through any more hoops for BC/BS Anthem. I self payed in Mexico, 8500.00 cash. There are all kind of low interest financing options, capital one, and bunches of others from your doctors office. I qualified for a 2 percent interest but just took it out of savings instead. Good luck those insurance companies can go to you know where as far as I'm concerned. My husband and I pay them 619.00 per month and won't cover crap. What a rip off. I'd be better off to put the 7000 per year in savings and pay my own bills. LOL

Betsyjane · October 21, 2006

How do you know who is good in Mexico? I hear such horror stories......

Maggie63 · October 27, 2006

Betsy Jane-

I fought Health America and won...and you an too. More and more people are winning thier appeals. Health America is going to start covering lapband for federal employees because of all the appeals.

If you want help feel free to PM me or go directly to the lawyers I used, Kelly and Walter Lindstrom (e-mail address is under my thread "We fought HA and won"

I think the tide is turning here and before long Lap Band will be covered like Gastric.

Betsyjane · October 27, 2006

I'm ready to give up. The doctor I carefully chose and was enthusiastic about doesn't take Medicare. Medicare only covers people in their Centers of Excellence. So I called Medicare and was told there are no bariatric surgeons and I should just call general surgeons until I find someone who takes Medicare and does lap band. I refused to hang up, insisting that somewhere there must be a list of Medicare Centers of Excellence, since they apprived them. After 20 minutes, she was able to give me the name of 2 hospitals locally, with no phone numbers and no surgeon's names. Medicare won't apy for outpatient...only inpatient.

So I called one of the hosptial's bariatric units and the woman who answered refused to answer any questions, saying she needed a coordinator to call me, but that she wouldn't do that unless I gave her all of my personal information first. By then, I was tired,a nd told her I wanted to give her my first name and phone number and I wanted a call back. She said she could only list me as anonymous then, and it would be a long time before I'd get to the top of the list. So I hung up, and went to thir web site and gave them feedback about how they have lost the surgery since their front door was too bureaucratic and uninviting, and explained what had happened.

So now I'm worried thqat any place that accepts Medicare is going to feel too crummy to me and I won't have confidence in their surgeons...or in their ability to get me through this well. Right next to the website for this hospital was a link to an article ab out 40% of bariatric patients developing complications. Yikes. When I clicked on it, there was no such website.

I'm in a nightmare. I need to go catch my breath!