**Unexpected Bad News

I went to Dr. Sudan's seminar and he told all of us to check to make sure exactly what the insurance company counted as "medically needed". Well I called United Health Care and I was informed that the surgery was no longer covered in 2007 and then they tried to tell me that it wasn't covered in 2006. I told my HR person that I wouldn't have started this process if it wasn't covered. I know that I looked up the benefits and saw that it was a coverage procedure...now everyone is telling it never was. So, I am beside myself and no way to pay for a $30,000 surgery. I am feelig low and depressed. I have to ice my knees now because they hurt so bad. My insurance said that no weightloss is covered...surgery or non surgery. I was with Dr. Anthone and he was trying to do a pannis removal surgery first, and my insurance company denied that all three times...we went through all three levels of appeals and was denied everytime. They viewed the surgery as cosmetic and not medically needed or beneficial to my health. I don't know what else to do. I was referred to a lawyer but she couldn't quarantee me that she could get the decision overturned and I can't afford to pay alot of money in fees. Does anyone have any helpful advise?

I have been battling insurance for three years. I was also denied all three times. it really stinks. I am now on disability( which was a two year process) alot due to weight issues and now have medicare so I got lucky. I know how depressing this can be I was devasted after my last denial I just thought it was the end of the world. But things have a way of working out. Maybe this attorney can help. Has she handled these kind of cases before? I wouldn't waste to much money, if not. I wish you the best of luck. Don't give up hope. I believe that if it's meant to be it will happen.

I am so sorry to hear about your insurance issue. I have waited over 7 years to finally get to the point I am now. I was forced to find a new job--thank the Lord that I did as my insurance now covers WLS. I too, had an insurance company that would not even consider WLS of any sort. I was blessed when I took this new job and did not even know it when I hired on. Not everyone can change jobs but it is an option worth looking into. There is also self-pay. Lap band is about the price of a new car. Perhaps you could look into it at the hospital you wanted to use. Check with your surgeon about it too. I know this is what I probably would have done if I did not have coverage. Right now, I am in the waiting process. + I wish you well, and I will pray for you to find the right answer. (But never give up hope.) When one door closes, a window will always open up. God Bless, Chris