HELP HELP HELP HELP HELP HELP HELP HELP HELP HELP (DID I FOGET HELP)

OKAY HERE IT IS I SUMITTED EVERYTHING INSURANCE HAS ASKED DONE EVERYTHING THEY HAVE ASKED AND NOW THEY TELL ME THAT THERE IS A CLAUSE IN HUBBYS INSURANCE THAT STATES THEY DONT COVER GASTRIC BYPASS. YOU ALL DONT UNDERSTAND I AM ONLY 22 AND WEIGHT 300 LBS I NEED TO HAVE THIS SURGERY DONE I HAVE BEEN ON DIETS SINCE I WAS 10 (YES 10) I KNOW THATS SOME BULL*&$^ I KNOW SO PLEASE ANYONE THAT CAN HELP ME WITH ANYTHING THAT YOU CAN TELL ME PLEASE HELP ME PLEASE I HAVE SAGAMORE INSURANCE (THROUGH HUBBIES WORK) I AM TRYING TO DROP HIS INSURANCE AND GET MINE THROUGH WORK WHICH IS AETNA WHICH THEY ALLOW THE SURGERY SO AGAIN PLEASE PLEASE HELP ME I AM ON YAHOO MESSANGER THE NAME IS [email protected] and you can call me i will give anyone my number that can help me

crap.....one day it is gonna be were all ins will approve this surgery...some are iron clad exclusions....when did they exclude this? when did you submit the paper work? (wondering if it changes the 1st of the year)

yeah i know i wish they would all change to cover it i dont know when they excluded it. when the nurse called to get my benefits they said that i needed to submit all the info and then they would give us the benefits and i have DONE EVERYTHING they asked

call the ins co again....call the human resourse where the ins comes from, such as your work or hubbys, ask each of them about self insured and fully insured...we get cheaper rates by excluding this surgery, or excluding any service they feel is not needed....find out the exact wording of the policy, if only the word obesity is used, without the words morbid, or a word to describe the extent of the obesity, it could be over turned....call gary,,,

Good things come to those who wait... and wait and wait... And you came to the right board!! WE KNOW ABOUT WEIGHT ISSUES HERE.. WE ALL HAVE HAD THEM...We know about being 300 pounds for a long time.. We just know the turmoil you are going thru now... Just know we are here for you!! Linda

Start the appeal process. If it is medically neccesary, you should have a chance. What medical co-morbidities do you have? make sure you have the doctors submit proof of those in your appeal. Good luck

it is medically needed i have diabetes high blood pressure and sleep apnea infertilty back pains

Cool...now submit your appeal and include a Letter of Medical Neccessity from your doctors. Include all the documentation for your co-morbidities and then wait for their answer...if they say no again...consider getting an attorney to appeal the 2nd time....or do the 2nd appeal yourself. They expect you to give up...don't do it...keep appealing until they approve you. Good luck!!!!!!!!!!

is there anyway you can let me know what all i need to include in the appeal letter if you think you could help me call me at 812-365-3202 please i need to get this done fast

Double check to see if it is covered when medically necessary. Sometimes the exclusion clauses do not apply. If you are switching to Aetna, make sure that you have detailed documentation of your weightloss attempts. I dont know if it has changed but you had to have 6 consecutive months of physician and dietician supervised documentation. A simple letter would not work. Best of luck. -Amy A