Denied once again......
Sad to say, but I was denied for the second time by my insurance co. I have already done the crying thing. Yes, I was really pissed and upset. BUT, I have accepted the fact. Now I am focused on starting WW just as soon as possible. I have decided to take all that I have learned over the past 8 months and apply it. I have learned a lot of things--especially about my health. I want to thank everyone on here for being so supportive and kind. I will still be here on the board because you all are AWESOME!!! You all are so supportive and inspiring!!
Connie H.
* I lost 7 lbs. on the pre-op diet.*
Oh, Connie...I am so sorry to hear that! Maybe Vicki will have some info that can help. I know she is our insurance Guru. Don't give up...we're here for you! Have you looked into Lap Band? Dr. Geller said that the Lap Band company has lawyers that will fight for you to have Lap Band surgery when you have been denied. I don't know if that is the surgery you were looking into...but it might me an option.
Kelly B
297/247/165
Summer Slimmers Challenge!
Most barriers to your success are man-made. And, most often, you're the man who made them. ~ Frank Tyger
297/247/165
Summer Slimmers Challenge!
Most barriers to your success are man-made. And, most often, you're the man who made them. ~ Frank Tyger
Yes, the LapBand was what I was trying to get approved for. This was basically my last chance. My husband changed jobs in December and starting January, we would have to go to Cobra and pay the premiums. He has insurance already thru his new employer, but they do not cover wls. I don't have insurance thru my employer. You all keep my spirits up and really inspire me. Honestly, this is the first time I have had a support group--well my husband supports me-but you know what I mean.
* I lost 7 lbs. on the pre-op diet.*
Connie,
I hope the info you've gotten in the last 8 months coupled with WW will do the trick for you!
I do want to share that you should maybe keep a little light burning for a self-pay option to get your band. I too was denied by my insurance but there was no appeal for me as there was a specific clause that said "no WLS of any sort for any reason" I simply said oh well and forgot it for several months. Then one day when discussing it with the hubby we came up with a plan to get it self-pay. I ended up using our equity money we had built up on the house! Yeah, i'll be making an $300 a month extra payment for a few years but it was TOTALLY worth it. LOL....no new car for me anytime soon! When it was time for hubby's turn with WLS we sold a vintage restored Bronco to cover his costs!
There are places not too far that have fairly good prices too! I think Dr. Curry is offering the band procedure for 12,500 when done outpatient. There's also the Mexico route but that one scares me too much so we didn't consider it too seriously.
Good luck, good bless and don't shut the door completely!
Oh yeah, with the way companies change insurance providers each year maybe things will turn in your favor next time they re-negotiate!
I hope the info you've gotten in the last 8 months coupled with WW will do the trick for you!
I do want to share that you should maybe keep a little light burning for a self-pay option to get your band. I too was denied by my insurance but there was no appeal for me as there was a specific clause that said "no WLS of any sort for any reason" I simply said oh well and forgot it for several months. Then one day when discussing it with the hubby we came up with a plan to get it self-pay. I ended up using our equity money we had built up on the house! Yeah, i'll be making an $300 a month extra payment for a few years but it was TOTALLY worth it. LOL....no new car for me anytime soon! When it was time for hubby's turn with WLS we sold a vintage restored Bronco to cover his costs!
There are places not too far that have fairly good prices too! I think Dr. Curry is offering the band procedure for 12,500 when done outpatient. There's also the Mexico route but that one scares me too much so we didn't consider it too seriously.
Good luck, good bless and don't shut the door completely!
Oh yeah, with the way companies change insurance providers each year maybe things will turn in your favor next time they re-negotiate!
~BECKA~ Start - 254 / Current - 172.6 / Goal - 160
Just another Bariatric Babe!!
Just another Bariatric Babe!! 
Oh Connie I am so sorry to hear that you were yet again denied. I know Cobra is so outrageous to keep and probably the amount you would pay per month could = paying self pay in the long run probably.
As Becka said leave the door open to possible self-pay or take what you've learned and apply to WW. I wish you the best of luck
Vicki
As Becka said leave the door open to possible self-pay or take what you've learned and apply to WW. I wish you the best of luck
Vicki
I think I am going to go to the meetings. I need that accountability. There is a 9:30 Tuesday morning class in Prestonsburg. With the way I work (especially during tax season) that would be the only class I could actually make it to. I work close to the courthouse and the class is at the church beside Dairy Cheer, so it will be close.
I called the insurance co. just to see how many times I could appeal the decision and this was the one and only time.
I called the insurance co. just to see how many times I could appeal the decision and this was the one and only time.
* I lost 7 lbs. on the pre-op diet.*
I am so sorry to here you were denied. Do they give specific reasons? Can you get a lawyer to help with the process? He or she may be able to find a loop hole in the one appeal.
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HI Connie, I'm sorry you are going thru this, trust me I know it sucks, I dont know who your insurance company is, as I couldnt find it on your profile, but have you looked into to RNY? I have Aetna and had surgery almost 4 years ago and I know they and most other insurances back then wouldnt cover the band but would RNY, didnt make sence to me but how it was back then. If I was you and if your open to RNY, I would try to get approved for that, if you have done all the requirements then you may have a better chance getting that done instead. ALways worth the try if you to have surgery!! My best advice is DONT GIVE UP! I know people that were denied 5 times and finally got approved!! Good luck & hope things go well for you. I know how it is when this surgery is all you want & it really consumes your life trying to get it approveed!
XOXOXO
Tabitha
Goshen, KY
RNY 6-16-05
XOXOXO
Tabitha
Goshen, KY
RNY 6-16-05
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