I've been denied. BMI 49 How can I appeal to Kaiser ?

Hi I am hoping someone may have some answers. I am so upset my new PCP(I've only seen her once) told me I would meet the criteria for the surgery and I should increase my activity level so I did. I started swimming and I watched what I ate. BMI is now 44.4 (after 9months). I got a denied because I don't medically need the surgery! Ijust can't believe it. I cant walk up stairs without pain I cant run after my 2 year old I dont leave the house with her because I cant keep up with her and I afraid she will get hurt. I havent slept through the night in forever. I have high BP. etc... I am venting thanks. If anyone has a good Kaiser Dr that they see or any info I can use for an appeal I would greatful. Thanks again, Denise

Denise, I'm sorry about your denial - it seems like every insurance company has it's own rules and reasons. I don't have any info on Kaiser, just wanted to say that we understand how frustrating it is to need/want surgery so much! Many people end up paying for the surgery themselves because they know they need it even if the insurance company doesn't. It's great that you started moving more to get into better shape to prepare for the surgery. You should have some sort of appeal process you can go through with Kaiser, perhaps they will approve you if you continue to fight. Good luck! Carol C.

I just had surgery through Kaiser at the Sunnyside hospital and my bmi was only 47. Contact Mary Lou Greenwood at Kaiser Sunnyside she is the bariatric coordinator. Find out from her exactly what and why. I know they have a formal appeal process. Good luck.