Rain

This is my second attempt to get approval from my Insurance company for lap-band surgery. My first attempt was met by nothing but No's except from my wonderful primary care physician. I was told by the insurance company that it was specifically denied in my policy. I was told by the lap-band center that they no longer helped a patient to get coverage from an insurance company if their policy specifically stated the surgery was prohibited. My financial situation was horrible and there was no way I could afford cash-pay and as far as getting a loan, fuhgetuhboutit.But this time, things seem to be happening just the opposite. Mind you, I am still in limbo waiting on approval but at least things look good . . . so far. While my insurance policy still specifically states that weight-loss surgery is non-covered, I was told by their Customer Service Rep that I could send a request from my doctor to their appeals department. My still fabulous primary care physician wrote another letter and this one was even more severe than the last regarding my need for surgery. Of course, my health is worse but still, the letter even had me gasp at the seriousness of it. Next, I got a copy of their response to my doctor asking for further information. This had me excited merely because at least it was not a curt "NO!" The information they needed could only be answered by a lap-band surgery center, so I contacted the same center that I did previously but this time they sounded more than happy to help. I had to go in for a visit, of course, and refill out my paperwork since my previous file had been destroyed. However this time they were more than willing to help AND they were told by my insurance company that the surgery might be covered if it was determined to be medically necessary. On a down note, the lap-band lady did imply that my insurance company was notorious for saying one thing on one call and something different on another. Still, it was something positive and at this point, I'm hanging onto what I can.