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healthymom2012

Pre Op
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Posts posted by healthymom2012


  1. And my friends, based on my own experience, sometimes the refusal is not the insurance, but someone else. Sometimes it truly is the insurance, but other times someone hides behind that. And it leaves a taste like bitter bile in your mouth and in your life. [emoji22]

    Ah I see. Ok well thanks for info.



  2. I hope so too. I hope everyone that finds themselves at this point is.
    You seemed incredulous as to why people are nervous waiting to be approved. Just was trying to make a point it’s not an easy road for everyone.

    Guess I was just being naive and curious why people were nervous. I know a couple of people who had WLS with no issues with insurance. Now I’m nervous reading everyone’s posts. I was hesitant about joining a forum...this why. No need to be nervous if I wasn’t before! Lol



  3. There can be mistakes made when the clinic files too if they are unfamiliar with certain insurances.
    And I forgot - some insurances want you to follow the 6 month diet, and if you successfully lose too much weight by falling below the required BMI they could deny, also some have a strict 'no gain rule' during that 6 months too. And the EXTREME insurance that requires 5 years of documented attempts at weight loss. The last one I have seen two people on here struggling to find 6mos missing records - those may as well just say 'we don't cover wls' but may be required to by state law but then make dang sure it is close to impossible to qualify.

    Right and these are all things people should know a head of time about their insurance.
    My BMI needs to stay at 40 but I have co morbidity so I would be ok if I fell below that. I also need to show that 40BMI for 6 months. My doctors office has been amazing with making sure I’m in compliance with my insurance company.



  4. 1. Bariatrics not covered in ins plan
    2. Did not meet criteria. Ex. Those are the main reasons you could be denied, or postponed until you are compliant.

    Seems very straight forward. Those all things that I knew a head of time. I guess I’m wondering why people seem so nervous about getting denied???


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