No coverage for surgery in 2005
Well, here I am almost a year from when I started my WLS journey and still have not had surgery.... 
To make the story short I made my appointment for my first seminar in november of 2003...and it was for their next seminar on Jan 22, 2004.
I got a surgeon consult date in April (my surgeon was popular so I figured it was worth it...my PCP also wanted me to wait for him).
Well, then my appointment got moved to May, and then moved again...I finally met with him in late June....
Finally on September 1, they submitted my info to insurance and I was denied on September 23...they can't even tell me what was submitted...also, they told me I was on my own as far as the appeal went.... 
So, I changed surgeons...went through his process which was a lot quicker but still took a little time...I went to my first clinic for their practice and met with the dietician and exercise physiologist on October 5...and had my consult yesterday on October 28... 
I need one more test...upper GI before they will turn my info into insurance....that test is scheduled for November 4th.
Here's the sad part....My insurance is Blue Cross Blue Shield HMO of Georgia, and bariatric surgery in 2005 is a seperate rider that employers must opt for (and it costs extra)...in my case my husbands employer did not pick up the rider and therefore no bariatric surgery is covered in 2005. 
Well, the last day my surgeon is doing surgeries are December 13 & 14...so, it is almost 99.9% chance that I will not have surgery this year - or at all....cry, cry, cry.... 
I've put all my energy into getting this surgery...I even put my career on hold and have been only working temp jobs and have gone into debt because I'm only making a fraction of what I usually do...not wanting to get comitted and have to ask a new employer for time off for surgery as I had no idea when it would happen (and I thought it would have been before now). Also, the unknown about the insurance...if I went to work my husband's insurance would no longer be the primary...and it's anyone's guess if my new employer's insurance would cover surgery...or I would have to waive my insurance and then if I ever wanted it through my employer on subsequent years then I'd have to apply for it...and of course with my comorbids...I'd be denied.
So, it comes down to this a total year of my life that I can't get back that I've waisted, waisted, waisted...I don't even have words for how utterly crushed and devastated I am.
To make the story short I made my appointment for my first seminar in november of 2003...and it was for their next seminar on Jan 22, 2004.
I got a surgeon consult date in April (my surgeon was popular so I figured it was worth it...my PCP also wanted me to wait for him).
Well, then my appointment got moved to May, and then moved again...I finally met with him in late June....
Finally on September 1, they submitted my info to insurance and I was denied on September 23...they can't even tell me what was submitted...also, they told me I was on my own as far as the appeal went....
So, I changed surgeons...went through his process which was a lot quicker but still took a little time...I went to my first clinic for their practice and met with the dietician and exercise physiologist on October 5...and had my consult yesterday on October 28...
I need one more test...upper GI before they will turn my info into insurance....that test is scheduled for November 4th.
Here's the sad part....My insurance is Blue Cross Blue Shield HMO of Georgia, and bariatric surgery in 2005 is a seperate rider that employers must opt for (and it costs extra)...in my case my husbands employer did not pick up the rider and therefore no bariatric surgery is covered in 2005.
Well, the last day my surgeon is doing surgeries are December 13 & 14...so, it is almost 99.9% chance that I will not have surgery this year - or at all....cry, cry, cry....
I've put all my energy into getting this surgery...I even put my career on hold and have been only working temp jobs and have gone into debt because I'm only making a fraction of what I usually do...not wanting to get comitted and have to ask a new employer for time off for surgery as I had no idea when it would happen (and I thought it would have been before now). Also, the unknown about the insurance...if I went to work my husband's insurance would no longer be the primary...and it's anyone's guess if my new employer's insurance would cover surgery...or I would have to waive my insurance and then if I ever wanted it through my employer on subsequent years then I'd have to apply for it...and of course with my comorbids...I'd be denied.
So, it comes down to this a total year of my life that I can't get back that I've waisted, waisted, waisted...I don't even have words for how utterly crushed and devastated I am. 
Chris,
Im sure that I cant help the way you are feeling as I know and understand as I have been denyed already a few weeks ago. I can tell you in my search and tryingto get answers that it is my understanding that if you have your ins paperwork sent in and get an approval that they will accept that after the first of the year. Work hard to get your approval before the year is out and hopefully you can have it done shortly after the first of the year based on that approval! Good luck!!
Im in the process of checking on a 2nd mortage inorder to have my surgery.. so I understand your frustration!! Hang in there and if it was meant to be it will fall into place!!
Ginger
I'm so sorry, Chris. I just can't imagine how frustrated you are. My heart just goes out to you. It's such an uphill struggle for many. I was one of the lucky ones...but I'm a big gal and had two years worth of doctor's visits, including cardiologists, etc. to document the trouble my weight had been causing me. I just pray things will work out for you. Don't give up. Shake this off and call people and ask "Why can I do?" Good Luck to you. Hang in there. It'll happen. I just know it.
Don't give up, I went through something similar, I took drastic steps to get this surgery done whi*****luded losing my job and applying for Medicaid. Actually dealing with Medicaid was easier than with my insurance company. (Great-West) I totally despise that company. Fortunately, I was able to have surgery but in the process I turned down 2 job offers, now, I am paying for it. My logic was, I didn't want to accept a new position and then have to take off to have surgery. So I understand what you are feeling on that part. Again, please don't give up. Be up front with your surgeon stressing the fact that you have to have this done this year. I pray it will all work out for you. J.
How does the medicaid thing work? Do you know what the criteria is to be able to get medicaid?
I'm so glad someone out there understands what I'm talking about with putting EVERYTHING in your life on hold...with job, $$$, bills, ect...sounds like we used the same logic.
I'm glad everything worked out for your surgery!
Thanks for the reply,
Chris S 
Chris,
I have been in your shoes, and let me tell you girl.... I understand you feelings... Just remember one thing.... God will allow this to happen when it is supposed to happen!!! It took me two years! and it finally happened. It will happen for you to... Hang in there... When it is your time in his eyes... you will prevail!
Lots of hugs to you!
Connie
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