Denied by insurance!

I found out yesterday that I have been denied benefits for WLS. Why??? Because they say I need 3 years......3 years of supervised dieting. Now at almost 60 years of age, I have tried at sometime, every diet known to man. My BMI is about 58-59 right now and I personally don't think 3 years will help it much. Dr. Sundberg's office has said they will try to fight the decision for me so please keep your fingers and toes crossed and I will try to keep my mouth shut! But that hasn't worked for almost 60 years either so I'm not holding out for much luck!!

Hi Linda,Sorry to hear that...go to your personal Doc and get a copy of your records,read thru them and write down every time you had been to see him and mentioned your weight and a program or diet or ect. You might be surprised to see just how many are there I was! I had to do the same thing plus!!!But I fought back and won my approval so hang in there and Good Luck prayers in the air for you!! Lori

I would also write a letter of appeal to the insurance company. Really lay out what life is like weighing what you do. Also tell them of all the failed wt loss attempts. That coupled with anything from your PCP and Dr. Sundberg, may just turn the tide. I had Dr. Sundberg and I just love him. He is so caring and compassionate. And you know he really understands when you go to him with a problem since he's also had the surgery. You couldn't ask for a better surgeon! Lyn

Dear Linda, This makes me so made at insurance companies! What other medical treatment with a 5% success rate would be pushed onto patients. Can you imagine them telling someone with cancer or even just high blood pressure or cholesteral to try a diet remedy that only worked 5% of the time--and for three years! I didn't have a history of doctor supervised dieting--just some things at Weigh****chers and Nutrisystem. I did include in my letter seeking approval information about the likelihood of being successful on diets versus the success rates of the surgery. I told them that I wasn't so special that I'd be one of the 5% but that I could be one of the 70%. One of the points about insurance that I have heard several times is that since people generally change their insurance every three years, that by putting up roadblocks, insurance companies figure you'll be out of their coverage before you get approved and will be someone else's expense. Good luck with fighting it, Sally