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

Being Obese Is Pre-Existing...duh!



Recommended Posts

So I got a call form the doctor's office saying my insurance company has authorizes my surgery (yay)...but the catch, I cant have it until October 28th because I have a pre-existing condition. When I asked what it was, they said my obesity. WTF? lol duh, I didnt get thin, then big again.

So i have been calling and calling to try and figure this out.I have good insurance, its a PPO even have a coworker that got the band done 2 years ago. Same insurance, didnt have this problem. I know 2 years is a long time, but how is this a new thing? I have never been seen for obesity before, so how is it pre-existing?

Anyone having this problem or know how to solve it???

Share this post


Link to post
Share on other sites

I agree this is rather odd. I am wondering if they want you to do a supervised diet or prove you've made attempts previously to lose it on your own. My insurance company required a 6 month supervised diet and fitness plan from my doctor and nutritionist. I have never heard of such thing as obesity being pre-existing!! That is the most ridiculous thing I ever heard. I would definitely call the insurance company and press for clarification and asked for their written policy on bariatric surgery.

Remember you are the customer....you have rights to the information.

Good Luck

Share this post


Link to post
Share on other sites

I know right? I showed them records of having a personal trainer, who was also a certified nutrionist. I saw him for over a year, and on my own out of pocket. Also showed them my meals, cause I record almost everything I eat. Not going to lie, when Im out on the run i dont ALWAYS write it lol.

I have calls in to several people at the insurance company to try and figure this out. My insurance only requires a few classes be taken, which I have done.

Share this post


Link to post
Share on other sites

Wow, and I thought I was having a bad day :(

So sorry to hear this. It's really unacceptable, but nothing seems to surprise me anymore.

Share this post


Link to post
Share on other sites

Well the good thing is they didn't say NO. Actually, they said sure at the end of October. I would still press for more answers and policy in writing.

Share this post


Link to post
Share on other sites

Jim 1967 That is true, at least they said it was approved. But what I want to know is, what happens if I gain more weight, or do i need to redo all the tests and classes I have done then..what. Obviously once I get a hold of a live person from the insurance company I will get these answers. Who knows...just a really strange occurence.

Share this post


Link to post
Share on other sites

Indeed, very strange. Good luck!!

Share this post


Link to post
Share on other sites

One of your doctors probably tacked the diagnosis on your visit at some point without you even knowing, guaranteed. Granted, they SHOULDN'T be sending in claims to your insurance listing obesity unless they're actually treating you for it, but they do it all the time. I work in billing and lots of docs just add the diagnosis in with the mix of whatever they're seeing you for. My OB/GYN even put it down during my pregnancy.

Share this post


Link to post
Share on other sites

So I got a call form the doctor's office saying my insurance company has authorizes my surgery (yay)...but the catch' date=' I cant have it until October 28th because I have a pre-existing condition. When I asked what it was, they said my obesity. WTF? lol duh, I didnt get thin, then big again.

So i have been calling and calling to try and figure this out.I have good insurance, its a PPO even have a coworker that got the band done 2 years ago. Same insurance, didnt have this problem. I know 2 years is a long time, but how is this a new thing? I have never been seen for obesity before, so how is it pre-existing?

Anyone having this problem or know how to solve it???[/quote']

Hello at least they did not deny you! I would do what several people have stated continue to call the insurance company for more information. You have rights I am fighting now to have my denial appealed! I am working with the FL department of Ins, our HR advocate and I am filing an appeal directly with the insurance company! At least they didn't NO best of luck

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

    • 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.
    • RacMag  »  bhogue925

      Hi, I’m new here. I’m currently on the liver shrinking diet. So far so good, but I have to say I haven’t found a protein shake I like. Anyone have any suggestions please? My surgery date is September 17th. 
      · 2 replies
      1. BlondePatriotInCDA

        Fairlife Core are by far the best. They taste just as they are - chocolate milk. You can either get the 26 grams or the 42 grams (harder to find and more expensive). For straight protein look at Bulksuppliments.com ..they have really good whey proteins and offer auto ship plus they test for purity. No taste or smell...

      2. BlondePatriotInCDA

        Fairlife has strawberry, vanilla and of course chocolate. No more calories than other protein drinks. Stay away from Premiere, they're dealing with lawsuits due to not being honest about protein content.

  • 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

    ×