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

Recommended Posts

Thanks soul :-/ I think something got screwed up because I did everything on the list and the hospital said they received all documents and submitted but according to my insurance I didn't!?? It's mind boggling I don't get it? We're gonna get to the bottom of it .. So aggravating !! Just more freaking hoops to jump through, I'm sure they hope I accept the denial and leave it at that but heck no there will be blood were fighting this! And if it wasn't meant I'm just gonna have to accept that it wasn't gods plan and well idk what I'm going to do uhg

Share this post


Link to post
Share on other sites

Get em girl! Insurance companies want you to give in and give up but I'm glad you're not!! I made sure with my insurance every single form/paper they wanted and I made sure I had copies of each, my surgeons insurance ladies (while VERY nice) could be forgetful... I wasn't having any of that...

Share this post


Link to post
Share on other sites

Hang in there, baby girl. It's probably just a form or letter that got missed or misdirected somehow. Aetna denied my psych's claim for my testing & sent me a letter telling me she was not allowed to bill me for the cost. Turns out she just had to re-submit claim with a different code. I'll bet your denial is due to something simple & fixable. Take a deep breath & hit it again tomorrow.

Share this post


Link to post
Share on other sites

They said I haven't been obese for more then two years which is BULL I've never in my life been under 240-278 for the past 6 years ad they said I never completed a 6 month diet dietician thing when the insurance coordinator for Aetna gave me a 3 month diet dietician thing with physicals and clearance from doctors and psychiatrists I did everything they told me to and they are saying I didn't I'm SO mad I'm at a loss for words

There are no words to explain how sad I am for how you are feeling. This too shall pass.

This is also 90% of why many of us go to Mexico...myself included. I was told that I had not been "obese" long enough to qualify, after going through 6 months of testing (metabolic and otherwise). Insurance companies in the US will say and do anything to deny, deny, deny.

You have options.

I wish you the best and do not give up!!

Share this post


Link to post
Share on other sites

So sorry to hear about that, I have heard though that they deny most of the time hoping you will just dismiss it. Most people that have the surgery have gone through an appeal or two. If you have the documentation and have gone through their "hoops" you should have no problem. I also have Aetna, and my plan does cover bariatric surgery, but only at 50 percent. I decided at that rate, I would just go to Mexico and have it done on my terms. I researched and found a very reputable doctor and it is costing me less than $5,000. I figure that I will see that back in a couple of years just by eating less and eliminating some of my health problems. Don't let these people define what you know is best for you. If you really want this, you will find a way!! I am sending positive thoughts your way!!

Share this post


Link to post
Share on other sites

Hang in there, I was denied 2x and it didn't really take that long to appeal.. the girl doing the paperwork in my surgeons office was helpful but I think was missing something - it took the nurse in my surgeons office to set up a conference with my insurance to go over all my medical records to only discover it was a miscommunication somewhere .... I so know how you feel but don't let it get you down - just stay on top of everything and everyone to make sure they do their part.

Share this post


Link to post
Share on other sites

Sorry if you were offended. I wish you luck but everything I said was true. Getting denied by your insurance was not a political issue...it was a paper work issue. The world is always looking for someone to blame. Just check yourself. Again Good luck!

Share this post


Link to post
Share on other sites

They said I haven't been obese for more then two years which is BULL I've never in my life been under 240-278 for the past 6 years ad they said I never completed a 6 month diet dietician thing when the insurance coordinator for Aetna gave me a 3 month diet dietician thing with physicals and clearance from doctors and psychiatrists I did everything they told me to and they are saying I didn't I'm SO mad I'm at a loss for words

How much is the surgery where you're from if you pay cash?? I paid $10, 000 cash and it was done. Cheapest around my area and no hospital stay.

Share this post


Link to post
Share on other sites

My mom is working it out as we speak so fingers crossed! And I have the BEST Aetna coverage of all the plans and its a $25,000 surgery and we only pay $800-$1000 out of pocket. Thanks everyone! In trying to stay hopeful and positive

Share this post


Link to post
Share on other sites

Hey I'm new to this site trying to figure it out but I have aetna as well after four denials I was approved .Just let the Lord control your life. And keep appealing. Wish u the best:)

I don't understand why the heck Aetna is doing this and being SO difficult ! My surgeon actually said he has never seen something so ridiculous before in his career dealing with insurance companies its the first time he's seen this happen Im like GO FIGURE!!! My luck! So now I have to get as many doc letters as I can.... Perezjewels what was the reason for denial??? What did you do and how long ago was this!?!

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

    • Doughgurl

      2 days until I fly out to San Diego to have my Bypass Surg. in Tiajuana Mexico. Not gonna lie, the nerves are starting to surface. I don't fear the surgery itself, or the fact that I'm traveling alone, but its the aftermath that I'm stressing about the most, after this 8 week wait. I'm excited to finally be here, but I am really dreading the post surgical chapter. I know its going to be tough, real tough and I think I'm just in my head to much now that the day i here. Wish me luck, Hopefully I'm one of the lucky ones, and everything goes smoothly. Cant wait to give an exciting update,. If there is anyone else have a June bypass or even a recent one, Id love to have someone to compare war stories with. Also, anyone near San Antonio Tx? See ya soon with the future me. 💜
      · 1 reply
      1. Phil Penn

        Good Luck this procedure is well worth it I am down to 249.6 lb please continue with the process..

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

  • 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

    ×