Get insurance to approve without requirement?

[oklafarmgal 31]

Has anyone got their insurance to approve surgery without one of their requirements being met? Mine requires physician documented "morbid obesity" for 5 years. I meet all of the requirements except that one. I have been "obese" for that time, but not "morbidly". My bariatric office doctor said to not worry about it. I don't know if he has had luck convincing them or what. But, I am still concerned that I will be denied. Any thoughts or suggestions? Thanks.....

[DreamsOfSkinny 53]

Has anyone got their insurance to approve surgery without one of their requirements being met? Mine requires physician documented "morbid obesity" for 5 years. I meet all of the requirements except that one. I have been "obese" for that time' date=' but not "morbidly". My bariatric office doctor said to not worry about it. I don't know if he has had luck convincing them or what. But, I am still concerned that I will be denied. Any thoughts or suggestions? Thanks.....[/quote']

I'm being denied right now for the 3rd time because of the whole definition of "morbid obesity". Good luck!!

[VSG148Sz6 68]

Ok here goes...I just joined this forum to get answers as well but I feel unless I say something someone else won't get answers.....I had the lapband inserted march 2008....started at 237...5'8" (recorded but incorrect) so I met the guidelines. After a baby I went up to 259 then down to 193...lowest with band....I started having complications with the band....leaking....didn't feel Anything until three months in when started having severe pains. In and out of hospital resulted in the removal of my band.....we were waiting first for the insurance comp to approve fixing the band but they denied..."not medically necessary" since I was now not "morbidly obese"anymore.....

Then tried for the sleeve...denied again..."experimental bc my bmi was below 35.....I had the band removed to find out the tube cracked.....the band was literally cutting up my insides. Since surgery on October 2, I have gained 17lbs and now meet the 35 bmi but the insurance company wants a letter of medical necessity. Normal you would have to go under supervised weight loss program monitoring for 3 months but my internal medical doctor is hopeful that his letter showing my past six year struggle will suffice. If I don't get approve under my insurance I will try my husbands and if denied under his ill end up paying for it.....I find it ironic that they knew I had a weight problem approved the first device, then when it became defective I'm no longer a candidate. Nothing within my control.....I'll be patient and wait my turn. Hopefully all goes well by the summer.

[oklafarmgal 31]

Thanks for the information. I hope everything turns out for you.