Insurance denied me :/

[Edavidson 84]

I have Blue Cross Blue Shield and trust me, it is not that great. I have a $6500 co-pay before

they pick up the tab in addition to $100 per Dr. that I see in the hospital. I owe a lot of money

to the hospital and Dr.'s. But, I can pay on time which is what i have to do.

[gymbremom 27]

Omg thank you so much for pulling that information up. I have a bmi of 41 or 42. There explanation to me was that I was on a dr monitored weight loss plan and lost 40 pounds but did not keep it off in a years time frame. Therefore they feel I will not be a good candidate due to my "lack of complying" to the previous diets I was on. Are they serious?! It's not like I want to weigh what I weigh! If I could manage to keep the weight off I would :/

[Edavidson 84]

Exactly Honey, I am so angry at how insurance company's give us the run around over weight loss

surgery. There is not one weight loss surgery patient that would have gone through that procedure

if they were able to lose weight and keep it off. I don't want you to give up, you fight for this

if it is really what you want to do. Don't let them get away with it. Find out if your state

requires the insurance company to do weight loss surgeries and then call them back if they do

and tell them they will approve you. Good luck to you and let us know what happens. Keep the faith.

[gymbremom 27]

I live in Maryland and it looks like they are on the list of states who approve it. I am going to my pcp dr next Friday to see if he can write a letter also. That might help my appeal. I will at least appeal it one time. Thanks again for all of your great info. It is GREATLY appreciated!

[Edavidson 84]

I am so happy for you. If you have a letter from your PCP and you let them know that they are

required by law to assist you with the surgery you should be approved in no time. Have a great

weekend.

[Chanel22 19]

I'm not sure the reasons for denial-my BMI was 41, so I didn't need another reason.. They were saying it had to do with my paperwork -once it was the fact I gestational diabetes-I had it many many years ago.. I was like um ok? My surgeons office kept putting it through since I should've been approved no matter what..

[Edavidson 84]

you should get approved now. if you need me to research anything for you let me know. I will

assist you all that i can. I worked in legal for 12 years and I am a research bug. if someone

tells me no they had better have a good provable reason. Go to the mattresses, fight, fight, fight.

"You've got mail" i love that movie.

[larlar 19]

Go to Puerta Vallert dr hildago 4300

[alindsey 230]

Go to Mexico!!!

[Alex Brecher 10,515]

I am so sorry about this – what a devastating piece of news! I hope that, like the others suggested, you will not give up. Maybe your current primary care doctor or another of your current doctors can help you appeal to the insurance company. Or, maybe you will need to look around for a different doctor who can help. Some of the bariatric clinics may be more used to helping patients get reimbursement and other financing options than your current medical care team may be. This is especially true in HMO plans, which are so bureaucratic. Keep up the fight!

[AustinJackson 4]

Fight it to the end or pack your bags and goto Mexico. I've been looking to find groups offering lower prices for those denied insurance and I've had some luck finding a few good ones. You can do it!

[Alex Brecher 10,515]

Don't take no for an answer! I recommend a great attorney that's won many WLS appeals against the insurance companies, Walter Lindstrom from WLSAppeals.com. His first appeal letter and bariatric insurance “case” was his own, fighting to get his own approval of gastric bypass after his insurance company denied authorization. He won and had “open” gastric bypass surgery on June 30, 1994.

Here's his contact info:

Walter Lindstrom, Jr.

PRESIDENT & CEO

LINDSTROM OBESITY ADVOCACY

601-C East Palomar Street, #480

Chula Vista, CA 91911

WWW.WLSAPPEALS.COM

Toll Free: 1-877-99-APPEAL (877-992-7732)

Fax: 888-992-1188

Please let him know Alex from BariatricPal referred you if you do use his services.

[lisa0617 54]

What insurance do you have? I do billing for bariatric surgeons. I am hoping to start my journey next week. I am so afraid to be rejected. I am thinking of getting my letters beforehand. I had a dr turn me down and i got so depressed. This group really helped. Don't give up.

[gymbremom 27]

I have united healthcare.

[drmeow 323]

I'm not sure the reasons for denial-my BMI was 41, so I didn't need another reason.. They were saying it had to do with my paperwork -once it was the fact I gestational diabetes-I had it many many years ago.. I was like um ok? My surgeons office kept putting it through since I should've been approved no matter what..

Ridiculous! Having had gestational diabetes makes you more likely to become a type 2 diabetic at some point, so you needed surgery even more! I'm pretty sure insurances routinely deny lots of cases off the bat just to see if some people just go away. And yet my doctor's office told me that the insurance saves enough money in prescriptions alone within 2 yrs to have paid for the surgery. Stupidity.