Insurance denied my RNY

I just got word from susie at dr. chae's office that my insurance denied me, they say gastric bypass is a specific exclusion. I dont understand, everything I've read in my policy say's as long as its "medically necacery"(sp?) It will be approved. Has anyone else delt with this I have no idea what to do now. I feel like without this surgery I'm in an out of control car headed for a brick wall and all i can do is watch death come closer and closer........somebody please

Heather, I was denied through BC/BS about 10 days ago. I know how you are feeling. My policy stated that I had to have a life threatening condition to qualify for coverage. Since I don't currently have diabetes, or high blood pressure or anything of that nature, they denied the claim. Call your company and request how to go about filing an appeal. As for copies of what was submitted as well as a copy of the denial letter. Then start working on getting an appeal together. There are a TON of letters than you access on this site and people are great about sharing their letters. Don't give up - keep at it and have faith.

Hey there; May want to hire Walter Lindstom? www.obesitylawyer.com ? Good luck!! Judith

Heather, DUH, isn't obesity a life threatening condition. The federal government and mediacaid think so. I would put in an appeal and have your specialists write letters. I had my endocrinologist (diabetes)and my cardiologist, along with othopedist and primary care doctors all write letters which were I think sent in bulk. My insurance company must have decided that the surgery was cheaper than paying all those specialists. Will be praying that your appeals work. Had my surg on July 14th and am amazed at how smooth it all has been but then Dr. Chae is on in a million. Deborah