Anyone every been denial

I recieved my letter from emblemhealth (hip) stated I was denial not medically nescessary. this is such a set back advice whats next

Nooo baby it is not a set back You are just going to have to try a different way! DO you work?, and if so change insurance providers, but before you do, ask for a copy of your medical records/history that has all of your weight losses/gains, and a history of any diet methods you have tried. It is good to have this because if you do change health insurances they will need a history of this usually the last 2-3yrs of it. Also how much do you weigh and what is your BMI? OK you hang in there and something will work out just keep on trying!

am 230 BMI 41 am 5ft 2in am going to call surgery office monday to see whats next step i know they said i can appeal but thanks alot for the infro Am also going to change my PCP Dont really like him

Appeal, Appeal and Appeal again. I had to three times and it took 9 months. Finally I was approved. Do not give up keep fighting, they want us to give up. YOU are in control

thank you so much for the great advice am going to call my surgeon monday and write a letter to my insurance why i think i should be approve

Good Peeches don't give up! That's right appeal< and write a letter, because your BMI, is high enough to qualify you for surgery! Good luck and keep your head up!

I was denied and I appealed.
I strongly suggest that you appeal. I can provide you with a copy of my letter that I used to appeal. Several people on this site helped me by giving me there letter and I can do the same for you.
If you are interested, you can message me via this site with your email address and I will send you a copy of my letter. You will just need to make the changes so that it applies to you.

There are a lot of people on this site that were denied and appealed until they were approved, I am one of them.

Good Luck to you

thank you so much

Hey, along with what everyone else has said - definitely change PCP's if you don't like yours, and find one that is supportive of weight loss surgery.  A good PCP will be able to write a letter to the insurance company that says why the surgery is necessary for you, and how it will benefit your health.  They'll also run labs and tests for you to see if you have co-morbidities like diabetes, high blood pressure, cholesterol, or sleep apnea that would further qualify you for surgery (if you haven't had these tests already).

thank you sunnymicki i need it change my doctor is not 100% supportive i will be calling HMO monday to get a list of doctors in my area thank you so much for the advice god bless