Absolutely devastated...

[MarissaAnn 4]

I am extremely upset. I got denied. I got the call from the insurance coordinator this afternoon. I asked her what we do from here. She said she is going to talk to my case manager and surgeon and see what they want to do and see what my potions are and she will call me. I'm so mad. She said that basically family history doesn't matter (as far as insurance is concerned) and that my pcos doesn't qualify me either. Ugh I'm so frustrated!! AND to top it all off, I'm only 20 lbs away from a bmi of 40. I'm definitely appealing because I can't afford this if insurance doesn't pay. I am completely devastated. I really don't know what I'll do if I can't have the surgery. Advice on how to get approved when I appeal? Anybody got denied but won their appeal? help please!! TIA

[Mommabird 367]

I am so sorry to hear you were denied. I wish that I had some advice to give you. There is a thread on the pre-op board titled "I was Denied" dealing with Aetna. In one of the posts, there is a link to an advocacy group that helped one person one the thread get her denial overturned. I have to admit, posts like yours saying that Aetna denied you're surgery really stress me. I'm waiting to hear from Aetna myself. Hearing about them denying people doesn't give me a warm fuzzy feeling!!

[MarissaAnn 4]

@ Mommabird I'm anthem blue cross! Hope you get approved!

[Mommabird 367]

Sorry, I don't know why I thought you were with Aetna! However, you might want to go to the thread I mentioned for the link to the patient advocate.