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Scared To Get My Hopes Up.



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Anyone else go through this? I've tried to have WLS before and was denied by insurance both times. Always had a BMI over 40 but was told no... had medical records from when I was 11 years old to the date I applied showing my weight and weight loss attempts (I'm only 32 now).... yet they always found some loophole.

I'm with UHC now for my insurance. Like a dummy I picked the high deductible at the first of the year (the thought never crossed my mind to try again after being denied so many times in the past)... so I'm out of pocket at least 1,900.00 before surgery. I'm trying to get all labs, EKG, Chest Xray, UA, and EGD done at the hospital I work for so they're covered 100% (procedure anyway, not the doctor's fee) to cut down on out of pocket. I know a few people I work with who've had some form of WLS performed... so apparently they WILL approve it... I've called the reps a couple of times and have gone over the requirements thoroughly... and I'm meeting them now... just really really really scared to get my hopes up just to get punched in the gut again. Anyone else feel like that? How'd you get over it? Did you wait until your surgery date to let anyone know what you were trying to do? .... sucks.

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What about going through your HR office for help?

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I work for an insurance company- I would suggest you speak with an HR person. Perhaps they can make contact with the UHC account manager and find out what exactly is missing from thier precert review.

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On another note, yes- like I said I work for an insurance company and I am still nervous to get my hopes up. Def understand where you're coming from on that point.

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I haven't submitted to them yet. I have in the past with other companies.. I'm still going through all of the hurdles right now.

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I have UHC. Was approved the first time. I was determined to have surgery so I told a select few once I started the process. I didn't even have a surgery date until 3 weeks prior to surgery! Started process in Oct and had surgery in Apr. don't be scared. If you have additional questions feel free to message me. Good luck in your journey :)

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This is exactly want I'm scared of (a loophole for denial). My surgeon's office is requiring me to pay my deductible, out of pocket cost, $675 program fee, and 20% before they even submit to insurance for approval or denial. All this is non-refundable so that makes even more nervous about this insurance thing. I meet all the requirements of the insurance company but still have the fear that they will find something to deny me on. The only person that knows I'm considering this is my husband and I don't plan on telling anyone else.

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