Insurance Frustration Flip Flop for Anthem BCBS

[RJC5197 282]

At the beginning of the process I talked to my insurance company, Anthem BCBS of Michigan.

They told me that there would not be a 6 month diet wait program requirement.

With 40 BMI, revision I need for bad vertical band, and co-morbidities, my Dr. did not expect any problems either.

Insurance just came back and said medical issues of band has nothing to do with WLS.

If I was having band replaced, then they would approve now. But since I need revision to bypass, they want the 6 month documented weight loss trials.

I have been admitted in hospital 2 times in last 4 months due to banding problems, and cannot see waiting another 6 months?

Anyone else has this baloney? Any appeal on this that is possible?

THX

Edited March 14, 2016 by RJC5197

[UsernameTaken 283]

I am with BCBS and going through revision from band to bypass. I have to meet all requirements as if I haven't had WLS before, they require 3 month diet which I am finishing up this week.

[RJC5197 282]

Update:

I and Dr. talked to BCBS, and since my VBG cannot be repaired and no longer done due to complications, they will now only require a NUT visit and approve without delay. No 6 month wait period.

Hot Dog..., getting rid of this band ASAP.