Denied

[cat240 0]

I just got news from my insurance that I am denied. I am 32, feel very unhealthy, but apparently without being unhealthy they won't cover it. I would like to think about getting it done and paying for it-any ideas of an inexpensive doctor. I live in Michigan.:help:

[Wheetsin 714]

Many people go to Mexico because the prices are cheaper (and for other reasons, but it seems like price is the main one), and there's a surgeon in CO people have mentioned here, who has a fairly low rate.

Why were you denied? I was relatively healthy before my surgery, had never been on meds other than the occasional antibiotic, etc. -- had normal levels, good BP, no chronic illness or pain... and I was approved. What reason did they provide?

[tiredofbeingfat 0]

Sorry to hear you were denied by your insurance. If you meet their requirements for BMI and have other co-morbidities then you might want to try an appeal. Gather your own records if you did not do that and make them explain why. "Sometimes the squeaky wheel gets the oil". I know that insurance companies are getting better about covering the lap band because it saves them money later on- unfortunately not all contracts make it easy to get this procedure. That is a shame.

In my case, I got records from 10 years ago when trying Phen-fen and had copies of weight watchers cards and slim 4 life records-all showed losses and then big gains. It took some foot work but I was desperate to get this tool to help me get healthy. GOOD LUCK.

[faithmd 14]

I also live in Michigan, which insurance company is this? If your BMI is less than 40, most insurances will not cover it without two comorbidities. My surgeon considers having an immediate family member (father/mother/brother/sister) who has diabetes or heart disease as a comorbidity. So if you have family members who have these, there are your two comorbidities. Might be the way my surgeon writes it up.

(I keep saying my surgeon, I haven't had my pre-op consult yet, but I did attend that seminar and he's the one my insurance will pay for. so I guess by default he will be my surgeon :eek: )