Are you kidding me????

I just got denied for my gastric sleeve.  I just started crying. Not sure why I cried, but it was like 6 months of hard work down the drain. I did everything I was told to do. But because I lost weight on my 6 month program they said I was not a candiate. My BMI was 41 when I started this whole program. After the 6 month program I weight 249 and my BMI was 38. This puts me under the mandatory no comobility and BMI over 40. I thought they took the starting weight? The insurance lady at the surgeons office was suprised also. Outside of gainin the weight that I lost there is no appeal. And the out of pocket cost is around $15,000. I guess it just wasn't meant to be. I enjoyed talking on here and it was fun while it lasted. 

Is there any chance for appeal? I'm so sorry you're having to deal with this,  but I wouldn't give up yet. What does your policy say?  Do you have any comorbidities at all, like sleep apnea?  I never knew I had sleep apnea until i was tested.  Good luck to you!

I don't have any at all. Besides having back aches, knee problems and my feet killing me. I guess that doesn't count. I see your starting weight was around mine, did you have problems with your insurance company?

I'm still pre op, should be submitted for approval beginning of July.  My only comorbidity is sleep apnea.  I have other health issues,  but none that my insurance seems to care about. I'm hoping to get approved.  My doctors office doesn't seem to think I will have a problem,  but all I can do is wait and see. 

I hope the best for you. 

Thanks!  You too! Don't give up!  

Sounds like your doctor's office screwed up, they should have sent your beginning weight.I'd appeal and have your doctor write a corrected weight for starting weight. Maybe have him appeal for a peer to peer appeal. Don't give up yet at least try the appeal first and see if they will take the corrected weight. Talk to the insurance lady again and see if there isn't something you can do. If need be regain the weight and keep it until you can get approved. That's just not right.

I was denied twice for pretty much the same reasons. On the third and last try they finally approved me. You have to write a really good letter and have the Doctors office also call to appeal for you.  Include in your letter, every diet you've tried, any diet drugs that you have tried and failed at, talk about your pain and stress that you want to fix these problems before they grow into bigger issues. Be really detailed. Good luck

Thanks for the info. Do I need dates for failed diets?

No. I just put a list of every diet I tried and failed at