Medicare Denial Frustration

[Jonah 38]

Hi All,
I just got my “welcome to the bariatric dept” letter and a denial letter on the same day. The denial said I don’t have a history of failed diets. My GP noted my failures specifically in my chart though. I’ve done so many diets, and Weight Watchers more times than I can count. I remember being on WW in my teens. My first prescription diet was early elementary school for G-d sake!
Now I have to jump through appeal hoops. I have Kaiser (Oregon) via Medicare (I’m disabled).
Any tips and encouragement is welcome!

[gabybab 696]

I'm in Washington and got approved no problem. I wonder why they came to that conclusion? Hopefully your Dr will help you appeal and be able to document more information they need.

Best of luck!

[GradyCat 3,696]

I'm disabled and on Medicare via Humana and was approved with no problem, but I had a 40 BMI and two comorbidity factors.

[debra102364 148]

Hi All,
I just got my “welcome to the bariatric dept” letter and a denial letter on the same day. The denial said I don’t have a history of failed diets. My GP noted my failures specifically in my chart though. I’ve done so many diets, and Weight Watchers more times than I can count. I remember being on WW in my teens. My first prescription diet was early elementary school for G-d sake!
Now I have to jump through appeal hoops. I have Kaiser (Oregon) via Medicare (I’m disabled).
Any tips and encouragement is welcome!

Let me know what you find out. I am the process of doing all their requirements. My doctor wrote a letter of all the diets I have been on. I hope it will be enough.

Sent from my LM-Q710(FGN) using BariatricPal mobile app

[Jonah 38]

On 06/02/2019 at 11:01, GradyCat said:

I'm disabled and on Medicare via Humana and was approved with no problem, but I had a 40 BMI and two comorbidity factors.

I have a BMI over 60, pre diabetes, sleep apnea, borderline high blood pressure and a bad back. I thought it would be no problem to get approved. I’m hoping my doctor putting in more information will do the trick. ::crossing fingers::

[Jonah 38]

Yay! I just got approval from the bariatric department! Apparently they immediately reissued the request after it was denied. Apparently, they just needed more from my doctor. So I’m back on track.

[GradyCat 3,696]

20 minutes ago, Jonah said:

Yay! I just got approval from the bariatric department! Apparently they immediately reissued the request after it was denied. Apparently, they just needed more from my doctor. So I’m back on track.

That's great news! Good luck on your WLS journey.