Absolutely devastated...

[MarissaAnn 4]

I am extremely upset. I got denied. I got the call from the insurance coordinator this afternoon. I asked her what we do from here. She said she is going to talk to my case manager and surgeon and see what they want to do and see what my potions are and she will call me. I'm so mad. She said that basically family history doesn't matter (as far as insurance is concerned) and that my pcos doesn't qualify me either. Ugh I'm so frustrated!! AND to top it all off, I'm only 20 lbs away from a bmi of 40. I'm definitely appealing because I can't afford this if insurance doesn't pay. I am completely devastated. I really don't know what I'll do if I can't have the surgery. Advice on how to get approved when I appeal? Anybody got denied but won their appeal? I have anthem bcbs. What do I do?

[The Candidate 3,215]

I'm still in the approval process myself, so I can't give any inside advice on that level, but I just wanted to encourage you not to give up. Look into your appeal processes and fight for it at every level. If all else fails there's still the option of self pay. I know you say you can't afford it now, but maybe you can start saving. Mexico is a quarter of the cost and many others have gone that route and been fully satisfied with the results. I truly hope things work out for you.

[Jersrose43 837]

Who is the insurance ?

What were their reasons for denial? They should have sent you a letter detailing it.

You insurance coordinator sounds like a flake. The next logical step is appeal or peer to peer review of the insurance allows for that

If you are at a 39 bmi I would call your insurance and get their requirements directly from them.

[MarissaAnn 4]

@jerseose43 my bmi is 37. They are sending me the letter. I was also denied from peer to peer. I'm doing a personal appeal now. Hoping that an outside agency can review and will approve. I hear they are less strict with comorbidities. I am contacting an obesity advocacy group to help with my appeal. I thought I would initially qualify because I'm pre diabetic with PCOS and acid reflux.

[Jersrose43 837]

Who is your insurance?