I am sad and angry...

gunn4ya · April 12, 2005

Babs,

So sorry you have to go thru all of that with the insurance company. At any rate, I hope everything works out for you. Good luck.

Iluvharleys · April 12, 2005

Keeping my fingers crossed for you!

Bright · April 12, 2005

what crap news Babs, hope you fight it AND WIN! By the way, I hear great things from people in the UK and here in Ireland, that South Africa is pretty good value for plastic surgery....there are resorts where you come back to after the surgery and rest for two weeks....just a thought - really hope it works out for you xx

flower · April 12, 2005

I heard that you can submit a bid for approval again you might have to document consequences such as rashes, chafing , yeast infections you have to keep fighting the sqeaky wheel gets what they want.

Zoe · April 14, 2005

... they agreed to honor the previous approval for the abdminoplasty. SO yeah!!!! It must have been the threats that I would sue them for backing out of the previous approval that got them off their butts...

Well, at least you've had some good news. Now let's hope they go for the thighplasty, otherwise it's ass-kickin' time.

babsyintx · April 14, 2005

Hi Zoe,

Like the boot.

I'm hanging in there. I am getting all my ducks in a row and will fight tooth and nail. I am still optimistic. Hey, at least I can get the TT.....

Babs in TX

judybellyband · April 15, 2005

Oh my word!!!! What state & insurance company do you have . . . I want to make sure I NEVER use them. Why is it that they are even in this business; must it always be anti-patient and pro-holding our money. Babs, please know that I am praying for you and hoping it all get's turned around for your good very quickly. It is a shame for sure and I am very sorry this has happen to you. You have done so well in lossing so much weight; please, don't let this get you down. It's just a crazy world.

Always,

Judy

babsyintx · April 15, 2005

Hi Judy,

I actually have really good insurance. They paid for my lapband and made a decision in one day! They are paying for my Tummy Tuck, but did not feel that the pics and clinical data was adequate to approve the thighplasty. I am appealing and still have two appeals left. Hopefully, I wont have to use them all. Not many insurance companies want to pay for thighs. Most of them dont want to pay for anything. I think statistically only 40% of people who get the lapband actually get their insurance companies to pay for it. I am here in TX and have the Motorola Rewards PPO administered by Humana Choicecare. Things used to be easier when CCN was the network provider. They do pay for my fills (I have had 7 and they paid for my band, so I cant squawk too much. IT is disappointing to be turned down, but I think with an appeal, I should be able to win this. We shall see.....

Babs in TX

judybellyband · April 15, 2005

Dear Babs,

I LOVE that spirit and I do so hope they will quickly come through for you. Please keep us posted and know that we all care. You are such a special person and a true lap-band sucess and roll model.

Always,

Judy

I'llsucceed · April 16, 2005

Way to be presistant Babs!!!!!! I am very happy they decided to honour their first ok on the TT & I pray that your thigh lift will go through as well. I will keep you in my prayers. I never had any idea how long a prayer list could be until I joined LBT:0)

I hate the fact that strangers can determine what makes us comfortable in our own lives. Who is anyone to say if someones thighs will be better lifted or not? Only the person dealing with the problem can truely say how it effects them.

DeniseG · April 16, 2005

I wish if they weren't going to cover the surgeries they would just not cover any surgeries. It ticks me off when I find out one person can qualify and another can't.