I can't do this anymore.

Jackie, Sorry that I worried you. I justed wanted to see if there were more people out there that were denied by medical mutual. I hope that they will come around and approve us for the surgery. Thanks for the prayers. God Bless, Marlo

It is ok Marlo, It has been a rough 8 months here. Bills are starting to pour in and I am so frustrated with this whole process. They belittle us make us go through so much to only tell us we are denied. Our lives are in their hands and they know it. So far I have had a pleasant relationship with Medical Mutual, or is it MedBen? What ever I am told different things each time I call, but anyways I am praying for myself and you too. Jackie

Jackie, Thank you for the prayers. I have been reading about other people that have Medical Mutual and they also are having a problem. I was told to call MM and complain. I was aslo told to speak with a manager to let them know how you fell. Someone else also wrote that they called everyday until she got approved and that is what they want you to do. Marlo

marlo; i am answering w/out reading your profile-so please forgive if i ask dumb questions! i have med mutual and was denied and finally approved after second appeal- which i had to submit-- what are they denying you about- specifically? have you written to them to ask for copies- as you are entitled to--of what they used to determine that you were not qualified? how much time is left in your appeal process/ who is writing this appeal? my doc's office wrote my first one and i do not think they wrote a very strong case. what are your co-morbs? how long have you been MO? please do not give up--many many of us have been where you are and it is no fun...persistence pays off and the end result is eventually worth all of the fight. email if you wish....margo

Margo, Thank you so much for your reply. They denied me because they said that I had to have 6 months monitered by my doctor and at least 2 years of deiting and exercise. I have all of that, so I hope that it will work. I have diabeties, high blood preasure, acid reflux, arthritus and high chloresteral. I am not sure how much time I have left for the appeal, but I will call and find out. I will also find out how many appeals I can have. Thanks, Marlo

when you were denied; it should have been in the form of a letter from med mutual. it will contain info as to how to appeal and should lay out the amount of time you have to appeal in. it also will tell you where to WRITE for the info that was used to make the determination. they will NOT honor this request via telephone. some of this is their way of weeding out who is serious and who just wants to be thin to look good. (my opinion only!)and they want to see how well you can follow directions. fight the good fight!

Hi Marlo, I truly understand how you are feeling right now. After researching this surgery for over 4 years, attending seminars all over the east coast when I traveled for work, I finally decided that I was going to go after it. I found a surgeon that I felt comfortable with, submitted to every blood test know to man, did my sleep studies, filled out countless paperwork and finally got it submitted to my insurance company only to be told that the surgeon was out of network!! Why didn't they tell me that when I called and asked about it?? No one could give me that answer. I called Dr Curry's office because I had read so many positive things on this site about him and made an appointment. So now the game has begun again. I was so depressed when I realized that I had been thrown 10 steps back, and probably not in the best frame of mind that I needed to be in when I saw Dr Curry. Now all I can do is hope for the best. Hang in there....you can't have gotten this far to give up now. I have a feeling that I am going to have to fight with my insurance company too! It seems common sense to me that they would rather pay for this surgery to make you a healthier person then to pay for all of the risks involved with being overweight. Just getting all of my medical tests done for pre-approval has cost over $9,000. Not to mention the meds that I take that they pay for, and the rental on the CPAP every month. Its a battle worth fighting for...Your Life!

Cathy, I am so sorry that you had to go through all of that just to find out your doctor was out of the network. I guess that I need to say hang in there to you. Good Luck with everything. Keep me posted. God Bless, Marlo

I have also been denied by medical mutual and currently in appeals. I know your frustration since they have approved four other individuals I work with. However, as others have suggested, do not give up. Since you are now going to a dietician have her sign off on each visit. Keep a food diary and if you are going to the spa or YWCA see if their computer can give a print out with the date and time of your visit. I know this is my next plan of action. Weigh****chers, food diary and spa visits as well as a once a month visit to my PCP. From what I have read, this seems to help with approvals in the appeal process.

Martha, Thank you for the support and suggestions. I will keep track of everything that I do. Please let me know what your out come is. Thanks, Marlo