OXFORD HEALTHPLAN

[SUCCESSFUL4LIFE 0]

DID ANYONE OUT THERE GET DENIED BY THEIR INSURANCE & HAVE TO APPEAL? I HAVE OXFORD & THEY DENIED ME FOR LAP-BAND SURGERY, BUT I APPEALED & NOW IN THE WAITING PERIOD TO HEAR BACK FROM THEM.

[bignat31 0]

DID ANYONE OUT THERE GET DENIED BY THEIR INSURANCE & HAVE TO APPEAL? I HAVE OXFORD & THEY DENIED ME FOR LAP-BAND SURGERY, BUT I APPEALED & NOW IN THE WAITING PERIOD TO HEAR BACK FROM THEM.

I dont have that insurance but just curious...what reason(s) did they give for dening you?

[Jess55 97]

Oh, I hope they don't deny often, I have Oxford Freedom plan. IMy paperwork should have been submitted and I m waiting for the surgeons office to call me.

[SUCCESSFUL4LIFE 0]

I also have "Oxford Freedom Plan" they denied because now that I've been losing my pre-op weight I no longer have diabetes. I have hypertension & joint & back pain as well.

I had to re-send the original medical records (from my Endocrinologist/Cardiologist/PCP/Lab-Band Surgeon/PCP) to proove that at my heaviest weight I was a diabetic & have something called "Weight induced Diabetes" & I have a strong family history of diabetes/Heart Disease/Obesity.

I typed them a two page letter stating why I know that I'm a good candidate for Lap-Band Surgery. If they deny again I will keep trying until they do approve.

I have a surgery date of 12/22/10. I want it this yr because I want to start off the New Year with a New Me. Plus the new deductible kicks in on 1/01/11.

Just pray for me.....

Oh, I hope they don't deny often, I have Oxford Freedom plan. IMy paperwork should have been submitted and I m waiting for the surgeons office to call me.

[SUCCESSFUL4LIFE 0]

They denied, because I no longer have diabetes because I've been losing pre-op weight. I guess they want you to be sickly before they will approve the surgery, but then on the other hand, my surgeon won't do the surgery at the weight I was at - I just can't win.

I'm not giving up. I am going to keep appealing until Oxford approves me.

keep your fingers crossed for me.....

I dont have that insurance but just curious...what reason(s) did they give for dening you?

[Mariasha 3]

What is your BMI?

Oxford is the easiest company to deal with.

As long as your BMI is over 40 they will approve you no problem.

[SUCCESSFUL4LIFE 0]

your BMI does not have to be 40 with Oxford or any other ins carrier... It's really the co-morbities as well as BMI & family & personal history of your health. I was approved yesterday after I typed & faxed them a two page appeal letter as to why I thought this procedure is right for me.. My BMI is 34 but went down from 40 since 2006.. My surgery date is Dec 22nd..

I am so thankful that I can now have the surgery - it's been a long journey for me.....

....

What is your BMI?

Oxford is the easiest company to deal with.

As long as your BMI is over 40 they will approve you no problem.

[mwinston2000 1]

I have Oxford, my BMI is over 40, got approved no problems, was banded Sept 9....... They are from what I hear one of the easiest to deal with and they don't require 6 month medically supervised diet. You should call and find out why you were declined, a lot of times the insurance companies don't have all the information they may needvfrom your doctor to get approved..... Call Oxford!!!