DENIED again

Well, I have been working on getting my thighplasty, and the appeal has been denied now. It says that the only way I can have a cosmetic procedure (which I dont feel that this will be costmetic at ALL!) is if it is due to a birth defect (isnt being born with fat genes a defect?) an illness (yeah, I think obesityis an illness) or an injury (bout ready to injure myself!@ grr) so, no go again. I am sure Grinnell will help me try to appeal it again, but it is not looking good for me. All I wanted was a little trim in the middle so I can walk normal! Well, I have set my mind to changing my life though. I have planned on going to work early every day starting in the nxt few weeks, and working out there at the hospital before work. something's gotta give! and if my back keeps going out, they can keep paying for it! Judi

Judi, Why don't you go over to the plastic surgery forum and ask for people to help you with their appeal letters. I've seem some really comprehensive ones posted there that might help you. Establishing that obesity is a medical condition, and how the effects of the weight loss have caused you more medical conditions, or something along those lines. Also, i don't know how much weight you've lost or how bad of shape your thighs are, but from what I read over there, the thighplasty is one narly surgery to recover from. Lots of complications, incision problems, and lots and lots of people needing revisions, or just generally unhappy with their results. Make sure you really want this, OK? Good luck, jean

Hi Jean.. well, I had Grinnell do most of the appeal process for me, I got them my records from my regular doc, and had my regular doc write up this AMAZING letter that was very good, in my opinion. I know we will appeal it one more time, but this letter from the insurance company pretty much says "no". My only other thought is that when I get married here (someday SOON! ) I hope, LOL, then I will have his insurance, and it is still BCBS, but a MUCH better policy. I will try it again then... Thanks Judi

Hi Judi, I am sorry to hear about your denial I remember when we met about a month ago at the camp out and how you were telling me about getting ready to get that surgery that is unbelievable how they denied you. There are surgeons that have applications to get loans I know you have to pay it back in payments but it might be well worth it. I would have grinell try to appeal it dont give up. I am really sorry it hurts bad when they deny something that you need. I wish you the best and don't give up. Lavonda

Hi Lavonda.. yes I remember meeting you, and yes, I was sooo sure they would approve the appeal. Grinnell was SO positive that it would go thru this time, and everything. the biggest thing is that it has to be caused by a birth defect, injury, or illness. and technically I guess they still dont count being born with major fat genes and stuff as a birth defect! LOL Well, once I get married to Ozz, I will have MUCH better insurance, and I guess I can just go bck to Grinnell and have them file it thru his policy then! dangit! Hugs Judi