my story

[blondie2 0]

Hello all,

I just wanted to introduce myself and and tell you my story. I am 37 years old, and have been slightly overweight, but physically active most of my life. I was diagnosed with lupus (mild) about ten years ago, have mild asthma, and have PCOS. For the last 6 years my weight has slowly creeped up to about 80 pounds more than when I got married, 13 years ago. My PCP has put me on Meridia, and the good part of phen phen. I was successful at losing some weight, but when I stopped taking them, I gained the weght back and then some. I started the band process last May. I've had my psych, passed, met with dr, nutritionist ect. I have been denied 2x once through appeals. Friday will be the 6th and Final dr. appt. for my 6 month supervised diet. I have lsot and gained the same 5 lbs during this 6 month process. Once I complete this appointnment doesn't my insurance have to cover me? I have BCBS of il PPO. According to their denial letter, I was just lacking in my completed 6 month- Which I will complete this Fri. Once again, Don't they Have to accept me once this is completed?:tongue2:

[MacMadame 81]

It depends. Once you get denied, you get a certain number of appeals and you have a certain amount of time to make them.

Plus, they can always find something to deny you for that they didn't notice before because they were focusing on this requirement

I'm not sure why your surgeon submitted your paperwork before you completed all the requirements. That could come back to haunt you, if it used up some of your appeals.