Denied

I was told last week that my request for Insurance was denied because I do not have 6 months of diet and excercise history. I had August through Sept and got pg in October so I was seeing a different doc.I ended up miscarrying on November. Any ideas on how to go about appealing?

Can you get the six months diet and exercise history they want -- even if it is using two different doctors. Most of the time if the insurance company has a stipulation like that you will have to comply. However, I have heard of some folks whose doctors wrote letters explaining why they needed the surgery immediately and the requirement was waived. Some insurance companies want the documentation of the six months to be in a specific format -- and want the actual case notes from your chart at the doctors. For still others I have heard of the doctor writing a letter saying that he/she has counseled you monthly and that is sufficient. It all depends on the insurance company's requirement. But take heart at least you do not have an exclusion. So if worse comes to worse you do the six months and then you will be approved. Red

I'm sorry... I have read where insurances will put you thru your paces before they approve you. But , the worst scenario is that you can start now with a doctor and just wait out the 6 months.  Did your second doctor address your weight? could he/she write a letter for you (along with the first doctor)?  When I started this whole process I started out with my pcp and followed up monthly so I would have at least 2-3 months history in case they denied me for that reason.... However, I found that my 2 health policy options both had specific exclusions... so am self pay now.

Hi I have been going to my primary care for the last 10 mouths because medicare requires that you have 18 mounths of supervised diet plans I now have a total of 17 done on June 4 I will have met my 18 m I have done all that I need for medicare that included the phy. and all that good stuff I am 47 years old and I have been over 500lbs and should of had surgery years ago.

That was one of the reasons I was initially denied, although I did have the proof and had submitted it.  I retained Walter Lindstrom, from ObesityAdvocacy.com and it was the best money I ever spent.  He charges a flat fee and offers several options.  If you choose the one that covers all the steps that may arise, he handles things all the way through appeals, independent reviews, and even litigation for the same fee.  He had the surgery himself and is awesome.  Good luck!