Insurance Denial for RNY

Sharon SW-267
GW-165 CW-167 S.

on 10/17/15 11:22 pm - PA
RNY on 12/22/14

Some employers offer different plans, this is the time of year that you can change plans. Check if you have other options. Sorry you are having this trouble.

Sharon

burgoya
on 10/18/15 7:53 am

Have you considered paying for it yourself? I used Lending Club and got a decent interest rate.

cc583
on 10/18/15 12:39 pm - Middletown, CT
VSG on 09/28/16

I never heard of a lending club. I will look into it. Thank you!

5'5" HW: 484, SW: 455,CW: 325

Surgeon, Darren Tishler

SkinnyScientist
on 10/18/15 4:17 pm

Look into a medical loan if possible.

Stay in the States or Go to Mexico.

If you are motivated and really want this surgery, MAKE IT HAPPEN.

I am so glad I did! I got my life back and so much more! It is definately richer than it was before and part of it is just being appreciative of getting my old beloved hobbies back.

If you want it, MAKE IT HAPPEN.

RNY Surgery: 12/31/2013; 

Current weight (2/27/2015) 139lbs, ~14% body fat

Three pounds below Goal!!! Yay !  

cc583
on 10/18/15 7:51 pm - Middletown, CT
VSG on 09/28/16

Thank you! It may not happen by the end of October as planned but I WILL MAKE IT HAPPEN!!

5'5" HW: 484, SW: 455,CW: 325

Surgeon, Darren Tishler

Eggface
on 10/18/15 8:15 pm, edited 10/19/15 6:20 pm - Sunny Southern, CA

OAC's Insurance Guide is a good read: http://www.obesityaction.org/educational-resources/brochures -and-guides/oac-insurance-guide

You might want to really review your policy and covered benefits... exclusions of all types of WLS or "if deemed medically necessary" sometimes that wording can make a difference in approval or denial and may be simple having your Dr send in documentation of an obesity related condition WLS/weight loss would be treating. http://wlsappeals.com/ is a great service that can review if you need assistance.

Self pay carecredit.com

Medical tourism (click on Forums above for the out of the country options)

See about getting a different policy for January.

Best wishes! It's worth the fight.

Weight Loss Surgery Friendly Recipes & Rambling
www.theworldaccordingtoeggface.com

cc583
on 10/19/15 2:35 pm - Middletown, CT
VSG on 09/28/16

I have now reviewed the policy three times and unfortunately even if medically necessary the insurance will not pay for it. Thank you so much for all of the information you have given me. I will most certainly look through it all.

No worries in giving up.....It's most definitely worth the fight!

5'5" HW: 484, SW: 455,CW: 325

Surgeon, Darren Tishler

sumaire
on 10/23/15 10:56 pm

When I was looking to see if my insurance would cover my surgery, I was pleasantly surprised to see that mine would be covered by the state of California through my Covered California (Medi-Cal/Anthem Blue Cross) coverage. (Thanks, Obama!)

Oddly, there are plenty of surgeons out this way who don't seem to think that it IS covered.

Good luck getting the help you need.

Roux en Y on 10/27/2016

HW 300 SW 284 CW 158 (4-26-2018)

cc583
on 10/24/15 7:12 pm - Middletown, CT
VSG on 09/28/16

Thank you! I may loose this battle but I will win the war! I will get my surgery sooner or later.

5'5" HW: 484, SW: 455,CW: 325

Surgeon, Darren Tishler

Anji
on 11/1/15 9:35 pm

Since you already have a surgeon, this may be an option for you. Or maybe you can use one of the surgeons already involved. Ten percent (an applicant's required contribution, if selected) is much more manageable than one hundred percent.

http://www.wlsfa.org/looking-for-help/how-to-apply-for-a-gra nt/


You will fight for it, if it means enough to you.

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