It figures

Howdy, Well it figures...got my denial letter in for my TT. Said it was "cosmetic" due to no rashes or complications....probably will do an appeal but not getting my hopes up. Gotta love insurance you get yourself healthy so they don't have to "pay out" for long term medical conditions and WHAM the one thing you do need & it's refusal. I didn't get my hopes up so was pretty much prepared for a "no" Unfortunately I had to have my hernia repair done..I imagine they probably would have covered the TT if it was mixed in with the hernia..but the TT was just too soon...as I'm not leveled out with the weight loss...(it's not a bad thing just that the hernias were reaking havioc) So while I HATE to dip into my 401K I'll be digging into it to get the TT done. due to my 401K plan being with my former employer I'll be taking the 10% hit for early withdrawal plus fed/state tax. The rest just throwing into an IRA...the positive is I can now "not worry" about the $$$ & now I can choose when I want the surgery which will be probably be October sometime. I'll be about 18 months out then & hopefully pretty stable with the weight. My hubby has been terrific through out everything & where he was disappointed about the insurance he just shrugged and said you know that you need to get this final piece of your journey done..then you can move on...he's such a good guy...Usually he freaks over financial stuff but he's been sooo good about my WLS & everything that has come along with it. What a guy! Santa will have to be REALLY good to him this year! Well for those of you who may have Coresource/Aetna just a heads up skin removal won't be an option unless you have some pretty big complications with it. Have a great night, Mickey

Sorry to hear about the denial,,but what do you have to tuck??? You looked fantastic at the picnic???Skinny,,,I cant wait to get there...But never the less,appeal,,,dont bail ship....Take care,,cyndee

Hey Mickey, Sorry to hear about the setback. Don't give up, Appeal! Lots of insurance companys turn you down the first time just to see if you walk away! Just like our "Journeys", Patience is the key to dealing with your insurance as well. If in the end they still won't go for it, Shop around, the differences in prices are quite amazing. I was approved for a "Panniculectomy" which is a tummy tuck without the stomach muscle tightening. It's fine by me , Will keep doing my "Crunches" till the day of surgery and it will be fine. The important thing is I get rid of this extra skin. The Lipo I'm getting will cost me extra but should be worth it.Good Luck on the Appeal and keep up the great work! You look Amazing ! Have a Great Holiday!

Michelle, Before you touch your 401K, make an app't to see a qualified financial advisor or an accountant if you have one. If you do it right, when you roll over your 401K into an IRA or some other plan, you won't take the 10% hit for the taxman. The other option is to wait until you are 18months+ out from your WLS and then lodge your appeal with your medical insurance carrier. Of course, if you do not have horrible rashes or a panni hanging way down, then "medical necessity" is not indicated anyway. Like you, I am entirely self-pay and will not even seek insurance coverage for my PS. I decided long ago to just suck it up and have my TT when I want and on my terms. I'm happy with this decision. Good luck and don't let the tax man have one nickel he's not entitled to! Mary

Hey Mickey, Sorry to hear about your denial sweetie, the insurance companies really stink. I hope and pray it all works out for you. You have such wonderful husband, I am so glad I finally got to meet you both. Take it day by day and it will all work out for you. I am praying for you to be able to do this for your final part of your journey too. Take care and email me if you need anything. Hugs KimC