Rain

Hi Lbers! Here's my story and I'm sticking to it. 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 my insurance company that any and all weight loss surgery 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 since 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 exceptionally helpful 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. Is there anyone else out there whose insurance company said the surgery was specifically denied in the policy but they allowed it anyway? Please someone give me some more hope.

Thank you so much for sharing your story, Sandi. I am in the beginning of my journey, still trying to get insurance approval. I have quite a bit to lose and your inspiration was just what the doctor ordered. You are awfully pretty. God bless you.

Good luck, you lucky dog, you!

While I can't answer any of your questions, since I'm still waiting on insurance approval, I wanted to tell you how much I like your handle.

I'm so jealous! I'm still waiting to hear if I get approval and have done little else. I'm looking at your signature and wondering how long it's going to take. I have a special event to attend next May that I'm hoping I will look a little normal for. Congratuations! Please keep us updated.