4th denial

Hi guys.  Wonderful news for Monica!!!!  I know she has been working so hard for this for so long!  Yesterday I got my 4th denial letter in the mail.  They said I don't have a psych eval, or 5 years of morbid obesity.  I called BCBS this morning to ask a few questions and got a voicemail.  I will call Obesity Law later today, because they are on the west coast.  Any suggestions???  What should I do??  My dad is still on life support and we found out on Saturday that he had a series of strokes.  This scares the hell out of me!!  I HAVE to do something w/ my weight.  I think the only thing that is holding this up is that I don't have 5 years of MO.  Why should I be penilized because I was not heavy in the past??  I am soo pissed now by the time this is all done, I WILL have high blood pressure!!! Kim 

Hi Kim: I am so sorry to hear about both the denial and your dad. As far as what you can do about the denial, I don't really know.  How long ago did your BMI get to 35?  If you have the date that it crossed to 35, and you have a couple of the co-morbidites, you may have to use that date as your 5 year starting point, instead of waiting 5 years from the date that your BMI became 40.  Maybe that will shorten it up a bit? I will keep you, your family and your dad in my prayers.

I'm sorry to hear about the bad news Kim.  My sister is going thru the same thing w/ her BMI.  She is so crushed and I don't know what to do to ease the pain.  My prayers go out to you and also to your father. Hang in there sweetie.. How is WW going? Christina

Kim, I am so sorry for this that you are going through. I can tell you the usually insurance companies are pretty strict if they have that clause in the contract. My sister with UHC experienced the same thing and they would not budge. Funny, she was covered by UHC with a different policy a short while later and she was covered and had her surgery. Chris

Kim.... You are heavy on my heart... Keeping you and your family in prayer, prayer, prayer! Keep fighting for your surgery! Anytime you want vent etc... know I'm here for ya! Jenn

Oh Kim, I'm so sorry that you didn't get the response you so wanted.  It does sound like they are hanging their hat on the "no 5 years of history of mo." I don't know if obesity law can do anything for you.  Be careful about paying a lawyler as they DON'T guarentee results. If you did meet all the requirments and were still denied I say absolutely go for it.  But they have that clause they can hang their hats on and will probablly win based on applying this condition equally to all who apply for coverage. I hope that I'm wrong though.

Oh Kim, this broke my heart to see that you were denied again.    Please do not give up the fight.  You may just need to step back and regroup. I also am sending prayers for your family, and sorry to hear about the events with your father.  I know it is hard to see someone you love in that state.

Oh Kim,  I am so sorry that you are going through all of this.  It just infuriates me that insurance companies have so much power and control over our lives. I know that they are a necessary evil in our lives, but it just is not fair that someone who doesnt know me or you from Adam has the power to make such an important and life changing(and saving) decision in our lives.  Hang in there - it has to get better.   I truly am sorry about your dad.  I lost my dad 2 years ago in a similar situation and it is heartbreaking.  I also am a CCU trained RN.  Even though I see it everyday, and feel my patients families pain, you truly dont know what they are going through until you go through it yourself.   Although I dont know you very well, I do empathize with you and if you have questions or need to talk to someone I am here.  I can tell you this   - keep the faith.  God has a plan for you and your father.  And although it is hard to think about it right now, everything works out the way it is supposed to.  I know it is hard to just give it to god but when we do, it becomes much more peaceful and easier to see the big picture.    Smile, Gina

Kim hon, I am so sorry about another denial and your dad.  If you need to talk, you know where I am.  My only advice is to take a deep breath. Dee

Hello Kim, I was also denied by Blue Cross and Blue shields, I also called obesity law, and they will help you. Even thought I did pay for my lapband surgery myself, because I just didnt want to wait. Obesity law appeal my case all the way to my benefits department. I had my lapband procedure in August of 2007 and in December 2007 I recieved an letter from The Benefits Management Division approving my surgery, so I will get all my money back. Keep the faith dont give up, thats what they want you to do., it  can happen for you Sabrina..