What now after denial of insurance?

When I was denied, I resubmitted with more information and after that...I appealed. In my case I strongly suspect that I was denied because it was almost the year end and my husbands employer changed ins companies. I feel they just pushed me off...  Jan 1st I had my surgeons office submit to my new ins. (BCBS of MA) I was APPROVED with no problems.  IMO if you can dig up some more health information and submit it...it would be easier and faster than an appeal. JMO...I went and had a sleep study and found out that I had sleep apnea - another co morbidity. Best Wishes and Hang in There!

im sooo sorry you were denied. this is also my fear. i am over 40 BMI now ( barely). my question is this: does BCBSNC require your BMI be over 40 for 5 years? ive gotten mixed info on all of this im also curious as to what july 14th means? wow i thought your high blood pressure would be a comorbity . if this is the case your BMI would have to be over 35. i hope someone can chime in on this. if you need to talk PM me. take care Melissa

yes, that is my understanding, but if you meet certain critirea then you would be approved without them even looking over your paperwork. The nurse at BCBS told me that they have let alot of people slide lately but that they were going to get tougher.I will not know exactly why I was denied until I get a letter of explanation but the nurse also told me that if my Dr was a center of excellance Dr then I would utomaticly be approved and he will become one on Monday July 14th.

Unfortunately, I had to delete this post due to privacy concerns.

Unfortunately, I had to delete this post due to privacy concerns.

THAT SUCKS---- I sometime hate how insurance companys have the control on our health Not the doctor.   I know how you feel , I was turned down and told NO WAY the surgery is too rishy ( what the heck ) - I was 327 pounds my BMI was almost 50 - But I am so greatful I was able to pull money from my retirement account and pay myself , best money I have ever spent - Poor as a Church mouse mind you but at a 150 pounds I have ne regrets-- KEEP fighting you have a chance with BCBS at least not like my insurance they do say YES to people. keep your sprits up Woman :)

Gaining 5lbs wont do you any good - BCBS criteria states you must meet for 4 of the past 5 years, if you have high blood pressure than that should count as a co-morb.... - you simply need to appeal. I was denied 3 times by BCBSNC for not meeting and on my final appeal got approved - it took me 4 months but I did it. They should have sent you a detailed denial letter - appeal exactly why they are denying you and just keep jumping thru the hoops.

 BCBCNC did me the same way and I was finally approved. Don't give up . It took me 9 months to get my approval and now I'm 3 weeks out and feeling great! Lynn

What was your BMI or comorbitities? What did you have to do to get approved?

I was thinking about all of this....Are you on blood pressure medication?  Has your BMI been at least 35 for the last 4 out of 5 years?  Did you submit all 5 years with 4 of the them with a BMI of at least 35?  I just don't see how they can deny you!!!  Who the hell decides whether or not your "comorbidities" are serious enough to require the surgery?  I don't get it!!!  If you meet the criteria, how the can they say no?  Sorry, all of this just ****** me off...and scares the living daylights out of me since my info. is going to BCBSNC Monday!!!  I know that in their policy it says that the "primary disease" has to require prescription medications.  That's why I was asking about meds.