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Insurance Denying Coverage of Surgery Scheduled in 3 Days Based on Assumed Alcohol Consumption

So I'm THREE days away from my surgery...more than a year into this program.my surgery is covered by my state insurance and I have complied to every criteria they have laid out. 6 months of nutrition classes, endoscopy, psych testing, quit smoking, don't do druids, don't drink, gave up coffee, lost 49 lbs, got the IVC filter...and 4 days before the surgery, they decide because I mentioned once in one of my many doctor visits in the past 6 months that I drink occasionally, that I did not follow the criteria for my state to cover the surgery. The thing is. I haven't had a drink, but I have consumed alcohol at random points in my life...weddings...party...once in a blue moon. I had to practically beg the lady at my state insurance co to believe me and I got an "I'll email the decision team and we will let you know." For real? Can this be before I start the Clear liquids diet on Wednesday and are you trying to test me??? Ugh. Thanks for letting me vent.

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I don't even know what to think...I gave up a job opportunity at freakin Etsy for this!! I'm filing a grievance with my insurance and the state's health care plan..but that won't do much..others have it much worse and I will hopefully still get my surgery.

Please keep us updated... thinking about you :)

  • 2 weeks later...
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So just checking in to follow up...I jumped through all of their hoops and now they have approved my surgery and I will be having it on Monday morning! Yay!

So just checking in to follow up...I jumped through all of their hoops and now they have approved my surgery and I will be having it on Monday morning! Yay!

My surgery is also Monday morning. Good luck!!

So just checking in to follow up...I jumped through all of their hoops and now they have approved my surgery and I will be having it on Monday morning! Yay!

Woohoo!

My surgery is also Monday morning. Good luck!!

Congratulations! I'm so happy for you!

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