Denied Again

I called my insurance company today, to see if they'd made a decision concerning my appeal for WLS. They have denied me again I have to complete a six month medically supervised diet before they'll approve me. I started this process last July, now I'm at a complete standstill until next May. I am so frustrated and down right now, it would be so easy to just give up. I'm now on blood pressure meds, in constant pain,and am going Jan 8 for a sleep study for sleep apnea. I just can't see what six months is going to show, that the last 30 years hasn't, but what choice do I have? My Dr. started me on a diet in November. I'm torn about trying to lose weight. I'm afraid if I show a loss, they'll deny me again, because "see you can lose it without surgery" I wish I had a dollar for every pound I've lost and gained over the years, maybe I could pay out of pocket, and tell the insurance co. to go to h**l!! Well hope everyone has a wonderful Newyears, and the best to all of you in the year to come!!! DeeAnn

DeeAnn, Im in the SAME boat your in. Read my profile we might have the same insurance from hell. I will tell you this "DONT GIVE UP" !!!!!!!!! I have 3 more months and I will have then compleated what they call "Supervised Diet" ...I have heard alot of things People say not to lose to much weight on the supervised diet because they could say that you were successful and that you can do it on your own and then Denie you....Stacy XOXO

Hang in There!!! I understand your frustration completely. (I am still waiting on status on if appoved/denied and am about to pull my hair out.) I think the insurance companies sometimes use this as a stalling technique to see if you will actually follow through, or give up. Well don't give up!!! Ins may also want you to show commitment to lifestyle change in diet to help aid the success after WLS. (This is my optimistic point of view) If they use your loss after diet as leverage that you do not need surgery, MAKE them understand that the pouch is a tool to HELP you succeed long term sustained weight loss. And back it up with your past attempts of loss and regain to prove your point, (my point, everyone's point) Diet alone will not do it for all people. In the mean time try to remain positive with chin up and continue toward your goal to become healthier and pain free. You have a huge support system here if you need it, make sure you keep us all posted.....

you need to appeal to the state insurance commisioner. Your insurance co. should have given you the address and told you how to appeal. It your right. If they accept your appeal and independent reviewer will be picked. The same thing happened to me and my Dr. wrote letters saying that I had been on many diff. diet. I sent them my life history and talked to the HR dept. where I worked. Nothing helped the the independent reviewer said that my insurance had to pay. It costs $25 to appeal, but if you win the give it back to you. Give it a try. Jim

Jim, How long did that process take ? Stacy XOXO

Dear Jim: Thanks for the advice!! Do you know how to get in touch with the insurance commissioner? I'm going to go ahead and look on line, but if you have any more info I'd appreciate it!!! Thanks alot!! DeeAnn

Sorry it took me so long to answer, been busy at work. It didn't take very long the state law sets down time limits for everyone. The whole process took maybe a couple of weeks. I will have to look up the address for the state insurance commissioneer, I don't have it handy. Jim

Hey got room in your boat for one more???? Just got a letter from BTC today stating they need documentation of 6 month medically supervised diet. Ins. told me something different, (not as specific) but got to play the game right? I WILL NOT GIVE UP!! Let me know what kind of diet the doctor put you on. Maybe we could compare... Good Luck and keep us posted.

i havent went to my insurance company yet but ive decided to use my money i recieve from the car accident i was in in may i ahve a lawsuit going so this is how much this means to me