Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Insurance Won't Pay!



Recommended Posts

I am in middle Ga and was just denied by my ins for the 3rd time. This means I can't appeal again. :( My Dr.'s office says they don't have a hernia repair/lap combo that would lower the costs. Does anyone out there know of anything else that could help? I was denied because my BMI went to 33 in 2009. So, according to BCBS, I haven't been consistantly fat enough. I can't handle it!!!!!

A couple of links are below. The first is for grievances against insurance denials in Georgia. However, if BCBS requires a 5 year history of morbid obesity (or a BMI over 35) you might not have a case. You might also go over to www.obesitylaw.com they are an advocacy group that help to fight insurance companies. See what they have to say.

http://www.online-health-insurance.com/coverage-by-region/GA/resources/page-25.php

http://guides.wsj.com/health/health-costs/how-to-appeal-a-health-insurance-denial/

Share this post


Link to post
Share on other sites

Not sure I can. The girl at True Results said there is an exclusion by the employer for no Lap Band Surgery.

I think I'm probably in the same boat. My company has an exclusion policy for weight loss surgery too. I'm going to True Results in Richardson and I have a consultation tomorrow morning. Amanda from True Results called me yesterday and said that my insurance wouldn't pay HOWEVER if they find an underlying problem, blah, blah, blah. So maybe if they find I have a hernia or something, we can get around that. Will know more tomorrow. I'm so determined to do this though. If I have to take the money out of my 401k, I will. I'm 61 and have been dieting since I was 12, so this is it.

Do you have a surgery date yet? Good luck to you!

Share this post


Link to post
Share on other sites

Had my consultation this morning. When the PA examined me, he said he thought from the looks of my stomach that I probably have a hernia. I hope so - in which case I'll only have to pay $5500. My insurance has an exclusion against weight loss surgery. I'm trying to get my endoscopy scheduled for 4/30 and that will tell for sure.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • cryoder22

      Day 1 of pre-op liquid diet (3 weeks) and I'm having a hard time already. I feel hungry and just want to eat. I got the protein and supplements recommend by my program and having a hard time getting 1 down. My doctor / nutritionist has me on the following:
      1 protein shake (bariatric advantage chocolate) with 8 oz of fat free milk 1 snack = 1 unjury protein shake (root beer) 1 protein shake (bariatric advantage orange cream) 1 snack = 1 unjury protein bar 1 protein shake (bariatric advantace orange cream or chocolate) 1 snack = 1 unjury protein soup (chicken) 3 servings of sugar free jello and popsicles throughout the day. 64 oz of water (I have flavor packets). Hot tea and coffee with splenda has been approved as well. Does anyone recommend anything for the next 3 weeks?
      · 1 reply
      1. NickelChip

        All I can tell you is that for me, it got easier after the first week. The hunger pains got less intense and I kind of got used to it and gave up torturing myself by thinking about food. But if you can, get anything tempting out of the house and avoid being around people who are eating. I sent my kids to my parents' house for two weeks so I wouldn't have to prepare meals I couldn't eat. After surgery, the hunger was totally gone.

    • buildabetteranna

      I have my final approval from my insurance, only thing holding up things is one last x-ray needed, which I have scheduled for the fourth of next month, which is my birthday.

      · 0 replies
      1. This update has no replies.
    • BetterLeah

      Woohoo! I have 7 more days till surgery, So far I am already down a total of 20lbs since I started this journey. 
      · 1 reply
      1. NeonRaven8919

        Well done! I'm 9 days away from surgery! Keep us updated!

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×