I haven't posted in quite some time. Probably because I was so convinced that I would be approved that I was just dancing along not worrying too much about anything. Well what a frustration ! Today I found out that my insurance took several weeks to get to my file, only to tell me that my doctor is out of network and not covered. I took a deep breath when they told me and thought...wait for it...."Duuuuuuuh".

I know he's out of network ! But you geniuses don't have a single lapband doctor IN network. You told me since there was no doctor in network that you would automatically review my file !

I'm trying to stay on the sanity train, but is it ever hard. Now I completely understand all of you that have posted all of your stories about insurance, and I definitely commiserate ! Not trying to be a downer, or a griper, but just typing that made me feel so much better.

Anyone else have something similar happen and have any suggestions ? This seems to be a first for my doctor. Thanks in advance for any suggestions.

Did the insurance say they would cover the LapBand if the doctor WAS in network? Or are they turning you down whether he is or not?

I wish I could help you but I am fighting the depression of having been turned down by my insurance.

I've spent the past two months going from doctor to doctor, having all the required tests, dieting to lose 5% etc.....only to be told my BMI is not high enough.....so the answer is no.

I feel so upset about this........I was told by the bariatrics office staff that with a BMI of 36.8 (and not the 40 the insurance requires) that I would probably be a good candidate because I have type II diabetes, thyroid disease, GERD, Barretts Esophagus, elevated blood pressure and cholesterol and mild neuropathy (due to the diabetes)..........Wrong!

Now I have to see if I can appeal their decision but right now I am feeling pretty discouraged.

Good luck with yours.

I dont know how long ago you were denied, but NYS has a department of insurance that serves to review cases on a 3rd party independent basis. I was turned down by my insurance company on the first go around. I appealed to the NYS department of insurance and was approved within 35 days. There are rules - I think you had to get the state involued within 90 days of being turned down, but should look into it