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Medical Director May Deny



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So I called to find out the status of my approval. Because I had a decent attempt at losing weight in 2008-2009 they will probably deny my claim. I hate the fact that I have evidence of me trying to lose weight on my own has caused them to probably deny my approval. Why do they want me to just sit around for 5 years being fat so I can have surgery? I lost weight, but I can't keep it off on my own. So even though I have been overweight for about 75% of my life that doesn't count. I just don't get it. Because I fought and fought and never really succeeded, but wasn't at 40+ for five years (mid to upper 30's) they say no?

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Try not to stress yourself too much before you get your answer, but have a plan ready. You can appeal. Get a peer to peer consult with your doctor and the insurance's doctor. Don't give up! Good luck!

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They most likely won't deny because of a previous weight loss success. Gosh, many of us here have had successful weight loss and gained it back. It's just a process and the worst that will happen is that you (actually your doc too) will appeal it. no sweat just a little time consuming. Hoping for a speedy approval..... ;)

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Thank you for the encouragement. I actually called back to talk to a different rep and got a lot more info. Like all bariatric surgeries go to the director. And that there were no notes about me possibly being denied. She said the reps can't say if someone might be denied or approved because they don't have that info. So she said to just hang tight and think positive. And she apologized for the other reps pessimistic approach this morning. While it wasn't a yes, it was better then the expect to be denied from the other rep.

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