More bad news...

Hello all...Needing to vent...I spoke with a person at work today who used to have my insurance (Vista) and tried to get approval through them and could not get any...she said it was appealed and even provided them medical requests from several different doctors stating that the surgery was a neccesity and they still would not apporve...then she stated that another co-worker with the same insurance even got an attorney..and still could not get approval from them for this!! I emailed an attorney yesterday (ObesityLaw.com)..got an email back from them today stating that they have dealt with this company before and have not had any success in getting approvals and did not feel comfortable taking my case!!! Sooo looks like I am not going to have any luck!!! I am soooooo upset now!! I am going to send in the appeal anyhow..but my only luck is changing insurance companies to Humana during open enrollment, which is not until November and doesn't take affect until January 1st!!! (5 months away) Then that means I have to start the whole process over!!!!!!!!!! :o( I am so bummed!! I just pray that Humana doesn't change there policies for next year??? As of now, the policy my company has with them covers the procedure!! Anyhow..Thanks for letting me vent!!! If anyone has ideas, please pass them on! Take care ~ Tricia p.s. I appreciated all of the respones from my previous post! t

Tricia, I have Tricare Prime which is serviced my Humana. All the policies may be different especially is you not not retired military as we are. However they do cover WLS but only open RNY. No word has been said they plan to change the coverage. I would jump on that one if I where you, they are easy to deal with.

Hi Patricia, I know how you feel. I work for one of the largest healthcare companies in the Tampa Bay area and my insurance at work excludes any type of obesity treatment. My co-morbidiities are so bad that it is affecting my job. I'm still working but, limited on being able to do certain things which is putting my job in jeopardy. I went to Vocation Rehab through the state of Florida and they are going to be paying for my surgery 100% because it is effecting my employment. They also have paid for all the pre-testing my surgeon requires. I just turned all my test results in to my surgeons office last week and am waiting for the call from their office for an appointment to see the doctor. My first appt was with his nurse practitioner. She goes over everything initially and gives you the scripts for all the testing. Anyway, the key to Voc. Rehab paying for it in my case is that the services they provide will help me retain employment. For those not working it would be that their health is preventing them from obtaining employment. I wanted to share this information with you in case you wanted to pursue this avenue. Whatever you decide I wish you the best. Nancy

Good luck Patricia, I'm sorry for the delay, I hope everything goes well for you.

Hello I have been following your post and I am so sorry for all the delays and what sounds to be bad news... But, as many people here know I am very much a Christian person and I believe that all things can be accomplished. But only with strong Faith!!! So all this negative news you let it roll off your shoulders and you keep heading forward as if you were before. You will have many prayers being sent out to you and please keep the Faith, its just the negative trying to pull you down, and don't let it.. You have your mind set on something and it can happen... God was the creator of all of us and more then you realize so pray that he intervenes and lets all this pass to let you have your surgery. Take care ~ Robin

Sorry to hear about the bad news. Just don't give up, keep at them until time for open enrollment. If you have to change insurance.... change, i had to myself. Just make sure you keep copies of all your records in case you have to change drs and surgeons too. Also if you do change insurance, i would go ahead and find out now what requirements they have for the surgery, especially if you have to have 6 months or more of supervised diet, and start it just in case. Anyways good luck and keep us posted. Tammy

Hang in there!!! Be persistent in your quest, and you know it never hurts to pray

HI, After years of fighting with my insurance company (Wal-Mart) I hit rock bottm. I wrote everybody that I could have. With nothing that could have been done. I contacted the Governor's office. They told me about Vocational Rehab. Now I don't have a job and I had to prove that it was medically necessary for me to have the surgery. Which was no problem at all. They also told me Don't call them asking "DO you cover the weight lose surgery"? You will get a out right "NO"! You make an appointment and see them face to face. Well to make a long story short. On May 7, 2004 I had my surgery paid for 100% by vocational Rehab. So yes there is hope. The rest is up to you.

Hi Patricia- You may want to inquire with another attorney. Gary Viscio is based out of New York, and I've heard he's helped quite a few people! Most importantly, he may be able to give you an alternate perspective for your case. His website is:obesitylawyers.com (Don't forget the www!) Don't give up-you deserve a happier and healthier life! :- )