jfran 0 Posted September 14, 2007 So I had my surgery 4 months ago and my insurance paid. Now my mom is wanting to have the surgery and our insurance refuses to pay. They said it was because her BMI is 39. She has tons of comorbities and a bad family history yet she doesn't qualify because she is one point below the recommended BMI. She even did the 6 months supervised diet like they ask. She resubmitted with a new weigh in where her BMI is 40. They were calculating it wrong because they had her height wrong. The insurance company reponded that because she had not been a BMI of 40 or more for 5 years she didn't qualify and they wouldn't pay. INSURANCE SUCKS!!! Anyways, my mom is down and has decided to self pay. It sucks because that money could have done a lot of good (bills). So she has a tentative date for Oct. 12th. I know she will be happier and healthier after banding, it is just sad that the insurance companies are like this. Just needed to rant. Hey at least they paid for mine. Better to self pay for 1 person rather than 2. Share this post Link to post Share on other sites
Margie122 845 Posted September 15, 2007 DId she appeal the denial? Sometimes that's all it takes...worth looking into. Margie Share this post Link to post Share on other sites
