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I won my appeal to the state insurance commissioner. I was denied by my insurance, Health Alliance, because they said I could not show Dr. supported weight loss. I appealed to the state commissioner and they agreed that the case should be looked at. It then went to an independent reviewer, picked by my insurance. They choose the Iowa Foundation for Medical review. All of my records were sent to them and they review everything and said my insurance has to pay. I was luck in that my wife's insurance covered me also so i went ahead and had the surgery done in sept. My insurance is primary and they should pay first and now they have to.

Good for you!!!! This gives me some hope for when I get denied again. Notice I say when, not if. I don't have a lot of faith in my insurance company. How long did it take after you went to the insurance commissioner? What all did you have to do to go to the insurance commissioner? Just want to get my ducks in a row. Thanks for any info you can give me! And Congratulations!! Sheila

Hi Jim! That is fantastic! Happy Holidays to you and yours! Blessed Be! Sherry

Great news for you!!!!!!!! More people need to do what you did. congrats on your win!!!!!!!!!!!!1 lynda

Wahoo!!!!!!! There IS some justice in this world! I'm sending your posting to a friend of mine who gave up before she even appealed. It might even be helpful to put your post on all the message boards-sounds like there are a lot of people out there in the same boat. It makes me sick that the insurance companies are trying to back out of something that can make such a positive change in people's lives! But of course as I have said before, they stand to gain even more by allowing us to wallow in our co-morbities racking up premiums with tons of tests/monitoring and downing expensive drugs!

When you appeal to the state commissioner, the law sets down the time frame. The state commissioner has 3 days to accept or deny your request. Your insurance company then picks an independent reviewer and you have the right to object to that. After the reviewer is picked they will review your case right away. It took about 10 days to have a decision. In case the Iowa Foundation called me to tell me that Health Alliance would have to pay. Your insurance company has to provide you with the proper way to appeal to the state. There is a $25 fee which the state will refund if you win. Hope this helps.