Very upset...

Ok as you all know I talked to the insurance (staywell) on Monday the 8th and they told me I was approved, well I was talking to my PCP today and they said they received a letter today dated the 9th that says I was NOT approved for the surgery........so I then proceeded to call the insurance company back and they said that he could only tell me if it was approved but he couldn't tell me that , that the doctors office would have to call the authorization dept for the decision...so I said so you are telling me today that it wasn't approved? and he said he couldn't tell me that only if it was approved or not so he wasn't saying anything...well needless to say I gather now that I wasn't approved and that this may be the end of the line...why would they tell me monday that it was approved...I was very specific on what I was calling for and he said yes ms bor**** had been approved this morning......this is all so overwhelming...now I am in tears afraid that I am just gonna die a fat person.....I can't take the pains in my legs, knee's and feet anymore...and I don't want to wound up in a wheelchair which is where I am heading...oh well...till I hear further news I will end this post...gonna email the surgeon's office to see if they received a letter yet..have a great coming up weekend all April

April, don't let it get you too down. Insurance companies are jerks..especially ours. This isn't the end of the line. You know that you can appeal and even more if need be. WHy would they not approve you hwen you have comorbidities and approve someone else that doesn't??? It's gonna pan out I just know it. Jen

Don't throw in the towel just yet. It took me a year to get coverage through my insurance company (Cigna). You should have an appeals process available through your insurance. And even after that you can file a grievance with the State Subcribers Assistance Panel (and insurance companies DO NOT like to be called to the carpet by the state). The only problem is that the state will not take your case until the entire appeals process has been exhasted (unless your insurance is causing unnecessary delays, in which case you can file a grievance for that). Anyway, you still have options. Don't let the insurance company get you discouraged. If you give up, they win (this is their goal).

Hi Jim thanks for the advice...my insurance Staywell is actually a Florida Medicaid HMO which I just don't know how much fight I can actually have with the state...but I am not going to give up..will fight them for all its worth and all that I have in me... have a great weekend April

April sorry to hear but don't worry it might still be aprroved, I myself have Healthease almost the same as staywell, well I called like you did and they told me I was approved when actually I wasn't. It took about 4 weeks between the surgeons office and healthease to actually approve it and I had everything they requested, 18 month supervised diet down to all medical records, co morbidities etc. When you call the only people that can actually tell you is the authorization dept, I found that out. Did your surgeons office call you yet or have you called them to see if you got approved or denied? Good luck and keep us posted. Any questions don't hesitate to ask. I had my surgery done in sept of 04 with Dr. Rehnke, best thing I ever did for myself, even though it took me over a yr to get it done. Tammy -149 total

Hi Tammy , thanks for that imput...I am hoping Dr Haickens office will know what to do...they are in the Staywell network so I am sure they can figure something out for me...I am going to try and keep for th faith for now.. Have a great weekend April

April I am so sorry, you are having a hard time. Did you get the name of the person who told you it was approved? Anytime I have called my insurance company or doctors office I always ask for names for back up in case of anything like that. ((((April)))). Vickie

Hi Vickie, funny thing is I always keep like a phone log of who I call and there names , the date and the time I called...guess what...I didn't this time , dumb on my part...but will definitely not do that again... have a great weekend April

April---- DONT GIVE YET.... THey told you were approved for a reason. Ask to speak to someone else if you dont like what they tell you. IF you remember the person you spoke to the first time ask for that person. And worse case scenario---appeal appeal appeal.. Hang in there girly it will all come through! and Becky

Hey Becky, it is always great to see your smiling face...I am going to hang in there...I am sure the surgeon's office will help me on this...am waiting for a reply from them today to see what they have received from the insurance and we shall go from there...there is a little fight left in me and I plan on using it all up... have a great weekend P.S. how are you doing and what is your weight loss now? April