Documented Eating Disorder And Insurance Denial

[skinny_minnie_wannabe 30]

I am currently waiting for my insurance to pre-auth my surgery. I had a psych eval which was done at the place where I have been going for years. I had never met the psychiatrist before. All seemed well until I was able to review my exam and he said that I had bulimia. This was not brought up during the eval. He had access to my medical records and I have a past history. It is no longer an issue. I have a policy through BCBS IL and they specify that they will not cover WLS with an eating disorder. Has anyone gone through this? Will I have the right to appeal the decision despite this requirement?

[TurnThePage 220]

Interesting that you were able to review your psych results. Never heard of that happening.

If their underwriting guidelines prohibit bariatric surgery if there is an underlying eating disorder, reason indicates there would have to be documentation that you no longer have bulimia before filing an appeal. There's a big risk of transfer addiction with bariatrics and I'm sure the insurer would be concerned that you might be adding physical problems to emotional problems if you had surgery.

Did you disclose your history of bulimia to the bariatric surgeon before they submitted for insurance approval? Talk to your surgeon's insurance administrator and to your insurance company about a possible appeal. If you are part of a group plan, you coverage may be different from other plans with the same company so answers you get on a forum like this may not be applicable to your situation.

[skinny_minnie_wannabe 30]

I transferred doctors and I had all of my documentation handed to me. I was being nosy. Thank you for the advice

[Danielr305 1]

I can never understand how health insurance regulators sleep at night being so ether being against or prejudice regarding patients with particular issues or disabilities regarding particular operations I really feel for you as I now gone 5 years having my RNY op and I cannot get my excess skin removed by my uk gov health system because I am not suffering with blood clots or because my excess skin is reaching the ground or have cellulitis. Despite being disabled with cerebral palsy also have a curviture of the spine and other probs the being made worse with the excess skin I have from the RNY op and because of the weight of the skin I am on opium based medications for pain. I now eat virtually nothing these days due to having no sensation of hunger ether. I will be honest I too have tried too get health insurance too get my excess skin removed with no joy because of of RNY op they won't cover the op I need. The only way I can get my excess skin removed I guess is get the uk gov health service too court but problem is getting legal assistance but I fight though my pain and sort of understand what u r going though with your plight. I will be honest too I was bullied badly at senior school and had 5 yrs of living hell I then went onto a residential college which of was raped by a evil carer over a 2 year period I was hurt physically too because I was going too tell but he got to me and hurt me before I cld say anything I never said nothing to no one for about 5 yrs after I left my college but I reported it to the police in a safe house I then was told he was charged and released but I cldn't take the animal to court because pple with learning disabilities were not recognised as witnesses under uk law until two weeks later due the law changing but because the uk laws run slightly different under welsh law we cldn't get him sentenced but he's on the sex offenders list for life and not allowed too work with vulnerable or children for life now ether which is something I guess welsh police did try too imply me a lier prior too my interview I then tried too overdose as I could live with times I was abused again but when I was discharged from hospital I got a sorry call from them they said we were sorry we did not know the additional information we had from my interview also I have and still have internal damage from being abused from this animal. I have had no support from my parents with what I went though but I just shown a stiff upper lip as British pple say but just live each day as it comes. But I see myself as survivor and not a victim. But u need too belief somebody will see sense someday and have humanity too help you as it is well documented many conditions with eating disorders are connected with obesity they must be lost in past some where in my opinion. I had a friend once whom had a severe eating disorder and mild learning disabilities ,also severely obese too with prader Willis syndrome which they are hunger all the time and the full messages never get though too the brain but despite her parents trying to get help they cld for her she died from her severe obesity sadly. I told a bit of my story and a bit of friends story because I understand sort of what u r going though and I also witness my m8 whom too had a eating disorder too so I know in many ways what r going though and remember u r not alone ever ok. So if your health insurance don't see sense then they don't have humanity to help when rightfully they should. I tried umpteen health insurance company's in the uk despite saying they will help anyone with any conditions at affordable prices which clearly is a blatant lie. My fingers will stayed crossed and I hope you get the good news u rightfully deserve. From Dan uk

[skinny_minnie_wannabe 30]

Thank you so much for your response! I'm sorry about your situation. Insurance companies can be cruel. It is a money making business. I don't think people should be denied for many reasons. It is terrible when people end up with other issues. This issues could get worse and cause other health complications. It doesn't make sense to me when they don't pay for things that could rectify problems before they get worse. You will be in my prayers. Take care