Please help! What can I do?

[time4achange 0]

Hello,

I went to my pre-testing today with my doc, only to find out that after speaking with my insurance Empire BC/BS of NY, they will not pay for the sleeve, that it was considered investigational. My Doc asked how could it get approved he was told that it had to be medically necessary to the point I coul not get any of the other surgeries. My hubby is totally against the bypass, and I promised my kids that I will not get the bypass.I feel like a liar. I feel like now, I am stuck with the Bypass. I feel so lost and depressed. My heart was so on the sleeve, I dreamed last night, that I had gotten it already.

My Doc said he asked around to other Docs to see what they knew, he was told Aetna and United Health care was approving the sleeve, other insurance was hard. I feel stuck and forced to do a surgery I do not want. I know I have to have something and I always said Lapband and Gastic was out. What can you do when your back is up against the wall, and you know surgery is the right option, but the surgery your heart was set on was stripped away, because insurance feel they know what's right for you!!!

[GayleSBennett 0]

A lot of people on this board are self-pay. Are you able to get a loan and pay for your own surgery? Or perhaps you can think of Mexico?

[MINI-Me 196]

Do you have any conditions that would make the LapBand and/or Bypass not optimal? Such as needing to be able to take NASID (spelling???)

I would talk to the office again. Have they had any luck getting the sleeve approved? I know that a few people on here have won appeals based on their medical conditions and the letters written by their doctors. Hopefully, they will chime in. In the meantime, do a search on appeals & see if you can find any leads.

Best of luck!

[time4achange 0]

Do you have any conditions that would make the LapBand and/or Bypass not optimal? Such as needing to be able to take NASID (spelling???)

I would talk to the office again. Have they had any luck getting the sleeve approved? I know that a few people on here have won appeals based on their medical conditions and the letters written by their doctors. Hopefully, they will chime in. In the meantime, do a search on appeals & see if you can find any leads.

Best of luck!

[time4achange 0]

I had 2 back surgeries this year 1 in June and 1 in July. So I do take NSAID, my doc just said that he could prescribe something else. I also argued that, for any pain I use Advil or Motrin. The bottom line is, I do not think he is willing to fight it out or me as I was hoping.

[MINI-Me 196]

I am sorry - is there anyone else in the area you can work with? Someone willing to fight for you?

[time4achange 0]

I am sorry - is there anyone else in the area you can work with? Someone willing to fight for you?

I do not know many doctors. I was referred to this one by my back surgeon. He happened to be in the same office. I am gonna start a new post about Doctor's in my area. Thanks so much for your response.