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Well was scheduled for surgery on Monday but got denied now my doctor has to fight for me! Goes to the review board Monday! Ugh!

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I'm sorry this happened to you. I hope you are able to get the denial overturned. Keep us posted.

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Pre existing clause sucks! Medically its necessary but the pre existing wait period over rules. My options are to wait until January or change insurance companies and see what happens...any suggestions?

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Is your insurance through your employer or individual coverage you took out? I'm in insurance so I have a bit of knowledge on this. Can you give me more details on the pre-ex denial?

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Sounds like individual insurance as you shouldn't have a pre-ex clause with group insurance through your employer. If you are thinking of getting another individual policy, you will likely to be subject to another pre-ex clause. You are probably better to wait put your current coverage.

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But the doctor said if I switch I'll have been covered for at least 6 months prior and as long as I don't have a break of 31 days or more between policies that there shouldn't be a problem

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I have a pre existing clause and I'm with a group plan through my employer .. I had to wait a year ...

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I have a pre existing clause and I'm with a group plan through my employer .. I had to wait a year ...

Wow! I haven't heard of that before.

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My coordinator told me that in order to get approved I had to show I been obese for the past 3 or 5 years...so of course its pre existing, but as long as I haven't went to a doctor to be treated for obesity and I never have. So I'm so confused!

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The dr with the insurance said that I was good to go medically but because of the pre existing week. I have to wait which is ridiculous but he's going to write that I'm good to go medically in the denial letter so hopefully that will help me when the waiting period is over unless I switch insurance company

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My coordinator told me that in order to get approved I had to show I been obese for the past 3 or 5 years...so of course its pre existing' date=' but as long as I haven't went to a doctor to be treated for obesity and I never have. So I'm so confused![/quote']

Your situation is tricky. Do you have any comorbidites that you received treatment for such as high blood pressure, high cholesterol, sleep apnea etc. Your insurance company could say those were obesity related and thus say you had treatment for obesity this making obesity a pre existing condition. It is really gonna depend on your medical records/history and the exact wording of the pre ex clause as well as state laws in the state where the policy was issued.

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I'm preparing myself just in case they do say its pre existing. My 12 months will be in January and I pray I don't have to wait. As. Many times as I've called my insurance about the requirements for surgery...seem like they would have mentioned if I had a clause. And another thing..they paying for my 6 month diet visits... so I hope they approve me! I been trying to get surgery 2 years and my hair is turning gray from worrying about(seroius) i m up all times of the night can't even sleep some nites.

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