So as you all know I was denied by my insurance. So I had to do an appeal. I sent in a lot of medical records a letter from my PCP and a letter I wrote. I sent all that in on Dec 30. They received it on the 31st. They told me it will be 30 days before they made a decision. So I checked about a hour ago and they reversed the denial and approved it. I AM TOO HAPPY. I TRUELY THANK GOD BECAUSE WITHOUT HIM, IT WOULD NOT BE POSSIBLE!!!!

I was denied because I hadn't had a BMI of 40 or above in the past 3 years, and I didn't have the required co-morbidities for the past 3 years. I do have co-morbidities, just not the ones that they recognize. I have high cholesterol, GERD, borderline diabetes taking Metformin to prevent getting full blown diabetes, knee problems and moderate sleep apnea.

I found medical records showing my high cholesterol for longer than 3 years, and I have a strong family history of diabetes, so I'm hoping that will be enough. I also found where I weighed in with a 39.1 BMI back in 2011, so that may help.

Oh ok. Can you get your doctor you see about your knee to write a letter saying if you were to get some weight off your knee that it will help with the problems you have been having? With my insurance (Aetna) GERD and sleep apnea are recognized. I have both of them.

I was denied because I hadn't had a BMI of 40 or above in the past 3 years, and I didn't have the required co-morbidities for the past 3 years. I do have co-morbidities, just not the ones that they recognize. I have high cholesterol, GERD, borderline diabetes taking Metformin to prevent getting full blown diabetes, knee problems and moderate sleep apnea.

I found medical records showing my high cholesterol for longer than 3 years, and I have a strong family history of diabetes, so I'm hoping that will be enough. I also found where I weighed in with a 39.1 BMI back in 2011, so that may help.

Oh ok. Can you get your doctor you see about your knee to write a letter saying if you were to get some weight off your knee that it will help with the problems you have been having? With my insurance (Aetna) GERD and sleep apnea are recognized. I have both of them.

I've included my knee problems with my other medical information. I actually had surgery on my right knee a year ago due to a torn cartiledge, but since then, both knees are stiff and painful. I have had to resort at times to getting a cart at walmart to shop. I've bought a cane to help when I need it also. They wake me up at night sometimes hurting.

BCBS recognizes sleep apnea, but only when it is severe, not moderate like mine, and I was only diagnosed last April, not 3 years ago, although I've probably had it for 3 years.

Oh ok! Well ill be praying that God touch who ever your dr will talk to for the peer to peer!! Keep me posted! It will work out!

LFG do you know "God is a wonder to my soul"? I think of the song when I hear of stories like yours. Surgery is around the corner. And health benefits to follow. God is a wonder...

LFG do you know "God is a wonder to my soul"? I think of the song when I hear of stories like yours. Surgery is around the corner. And health benefits to follow. God is a wonder...

Yes he is. I prayed and I said God its in your hands. I was doubting and I prayed and told God to help me with that and he did!! God is wonderful. Have you hear William Murphy "It's working"? WONDERFUL SONG!!!

Your story truly shows the power of prayer. I waited and prayed for two years about this surgery. I wanted the sleeve but my insurance did not cover it at the time. Late January last year I became very ill and was in the hospital for several days. I was told that I have copd on top of high blood pressure, no thyroids, sleep apnea, and diabetes. I was told I had to get the weight off. After several months of steroid shots I continued to gain. In July I really started praying that god make a way for this surgery. I called and got the process started in August. I found that my insurance now covered the sleeve and my out of pocket went from 2500.00 to 375.00. So God had not only answered the prayer for surgery, but answered the financial part too. Due to being in the hospital early in the year I had the surgery and only spent around 200.00. I no longer have the high blood pressure, diabetes, or sleep apnea. I am now down over 60 pounds and had surgery Oct. 30. We serve a great god.

Edited January 7, 201412 yr by Sherry73

Your story truly shows the power of prayer. I waited and prayed for two years about this surgery. I wanted the sleeve but my insurance did not cover it at the time. Late January last year I became very ill and was in the hospital for several days. I was told that I have copd on top of high blood pressure, no thyroids, sleep apnea, and diabetes. I was told I had to get the weight off. After several months of steroid shots I continued to gain. In July I really started praying that god make a way for this surgery. I called and got the process started in August. I found that my insurance now covered the sleeve and my out of pocket went from 2500.00 to 375.00. So God had not only answered the prayer for surgery, but answered the financial part too. Due to being in the hospital early in the year I had the surgery and only spent around 200.00. I no longer have the high blood pressure, diabetes, or sleep apnea. I am now down over 60 pounds and had surgery Oct. 30. We serve a great god.

Now that really was God. We serve a wonderful God. Yes we do!

Honestly, I think it's like applying for disability. They know that you qualify in the very beginning but I think they've made it standard practice to deny the initial application just hoping that many people will give up, which so many do and don't take advantage of the appeals process.

Bamaboo64

Your right. Lots of people do give up and don't fight. But they should fight for it. But what I don't understand is why insurances make it so hard. Think about it, people having the surgery will save them money in the long run because It will cut out alot of health issues by losing weight

Do you have a surgery date yet? If not, you need to let us know when you do so we can pray for you that day!

Do you have a surgery date yet? If not, you need to let us know when you do so we can pray for you that day!

No I dont have a date yet. I called the coordinator at my dr office today to let her know my denial was reversed. So I had to email her a copy of the letter Aetna sent me. She called me back and said the lady that does the insurance had to verify my benefits for 2014 and that they will call me to set a date!

Yippie!!!!! Keep us updated.

Yippie!!!!! Keep us updated.

I surely will!!!!

Yay! Congratulations!!!