They canceled my surgery
I have read your profile and I believe if you are willing to get all your medical records and get on a supervised diet for 6 months and will appeal to your husband's insurance who may not cover it under normal cir****tances - (if you have co-morbidity problems and you appeal under those cir****tances) I believe they will cover it. I will diligently pray for you to be able to have the surgery. Please keep me informed. I am sure you know that they are lots of people on the main board who would be willing to help you with insurance appeals when the time comes. They are some who may even know about you husband's insurance company because they have it?????? Keep me informed - in other words don't lose contact with us just because you aren't having surgery now. Sorry for the long post.
Listen, when I originally requested authorization for bariatric surgery through Cigna, WLS was covered. With my first request came a denial because I did not have a 6 month diet nor nutrition eval. In the process of me doing these things, my plan changed to such that WLS was excluded. When I appealed, they said it was an exclusion. I got a lawyer (Gary Viscio, the best) and we appealed. Again I was denied. We requested an external appeal and was denied. I send a grievance to the Agency for Healthcare Administration with Florida and we had an arbitration meeting with Cigna and the result was in my favor. Cigna was ordered to pay and my surgery date was postponed and postponed and a date was finally set. A week before the surgery, Cigna called and said AHA made an error and since my newest plan was covered under ERISA that Cigna is not obligated to pay. When they contacted AHA the lady told them they have no choice and they had to pay. This story took place in the time frame of 2 years. I had my surgery May 9th.
The point of this story is you will get your surgery. The insurance compainies try to prolong it and postpone it and hope you will give up but it will happen for you. It won't take 2 years granted but you're so close and the confusion seems easy enough (for everyone but your ins company) that you will prevail in the end.
Just be patient, think positive and keep posting (that's what kept me going through the turmoil)....
Dawn
Bethannie,
first let me say how sorry I am to hear this has happened to you.
Please don't give up. You're surgery may not be this month as you planned but it will come. Please keep praying. Many of us have gone through similar issues, but somehow in time; God's time, we were approved. I know right now you're thinking you were denied. But know that if this surgery is God's will He has only delayed you ,but He has not Denied you. I'm praying For you.
Morgan