Insurance has now denied my claim but my docs are going to try to get it overturned

I will never understand how insurance companies work. I thought they were there to insure we all stay healthy, but clearly they are there to save a buck. I am so sorry you are dealing with this one. I will be praying that on 1/4 you recieve your approval and will be post op by the end of the month. here is some "good luck dust" for you. Crystal

Hi Crystal, Thank you for your support in all of this. All hope is not lost however, my surgeon is not taking this lightly since I have a serious medical condition that warrants the surgery even if my BMI has not been high enough for 5 years running. They were recently successful fighting for another person that I know that was denied for the very same reason and they got the decision approved and she didn't have a co-morbidity like I do. I have a good deal of hope in my corner on this. Darla

I know that it has been awhile since you made the original post, but I really want to say this. I was denied by Aetna twice. Yeah, it was hard. And in my case, Aetna was not exactly easy to deal with at all. It was rather horrible. My doctor took the time to contact Aetna, and after that it was approved. It took months, but in the end I now have an approval and a surgery date. I'd be nowhere without my doctor's office, but it sounds like you have an incredible staff in your corner too. Just have faith in what they are doing, and give them every piece of documentation you have (not that you haven't already...that is just my main piece of advice for dealing with Aetna...document everything in language that cannot be interpreted, and expect them to interpret it anyway). Good luck! Jen

Hi Jen, Thank you for your input. It is a let down and it is clear you have been there yourself more than once even. I am very fortunate that my doctor tried to schedule a conference call with Aetna immediately upon receiving the denial. It's BUNK that insurance can literally make decisions that could have a serious outcome of health issues without help from this surgery. I know there are risks associated with the surgery too but the complication rate is so low that I believe, in my heart, it is worth the risk. I have every confidence my surgeon, Dr. Thomas Umbach, will do everything in his power to help me. God Bless You and Merry Christmas. Darla