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Denied

Feeling helpless just got a call from my surgeons office saying bariatric surgery is not covered by my insurance! I'm so depressed right now when i first had my consult they called for benefits stating i had 85% coverage now they're saying i have no coverage i just want to cry! [emoji24]

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  • Diana_in_Philly
    Diana_in_Philly

    Call your insurance and ask for a letter explaining why you are not covered and sending you copies of the section of the policy they are relying on to make the determination. They must provide that i

  • Don't feel discouraged. Do you know what they discrepancy is? It's weird that they initially told you it was covered, and now saying it's not covered at all. Maybe you choice give your insurance a cal

  • Walter.Sobchak
    Walter.Sobchak

    Call and find out what the situation is. Maybe it was just an error? I find it odd that they would tell you that you had coverage just to come back and say that you don't?

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Don't feel discouraged. Do you know what they discrepancy is? It's weird that they initially told you it was covered, and now saying it's not covered at all. Maybe you choice give your insurance a call and find out if you're covered for the surgery.

Keep your head up and best of luck!


  • Author
Don't feel discouraged. Do you know what they discrepancy is? It's weird that they initially told you it was covered, and now saying it's not covered at all. Maybe you choice give your insurance a call and find out if you're covered for the surgery.

Keep your head up and best of luck!




Thank you I'm trying to think positive just really sucks I've jumped through so many hoops already thought i did everything right. Ugh



Call and find out what the situation is.
Maybe it was just an error?
I find it odd that they would tell you that you had coverage just to come back and say that you don't?



  • Author
Call and find out what the situation is.
Maybe it was just an error?
I find it odd that they would tell you that you had coverage just to come back and say that you don't?





I agree I'm going to call tomorrow



45 minutes ago, Walter.Sobchak said:

Call and find out what the situation is.
Maybe it was just an error?
I find it odd that they would tell you that you had coverage just to come back and say that you don't?


Might be a reflex.. insurers are adept at saying "no"/"denied".

Call your insurance and ask for a letter explaining why you are not covered and sending you copies of the section of the policy they are relying on to make the determination. They must provide that if they deny.

I know it's hard but file an appeal....state why you need it and have doctors confirm why you need it. I'm studying in the healthcare/insurance area, so don't give up. Some insurance won't pay because it may not seem medically necessary but there is always a way, when it affects your health

Sent from my LGLS770 using Tapatalk

I just got my approval today- I was denied BCBS for revision to lap band removed in 2013... I was denied the first submittal (8/2016)and again when my surgeon requested a peer review. I felt rejected but finally took in my appeal the day before my 180 day period was to run out. I wrote a letter and thought for sure it was going to be denied again... approval arrived exactly 30 days after submitting my request. File the appeal!

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