Sure isn't easy!!!

I wonder if people that need heart surgery have to go through all this red tape. I mean, weight loss surgery will SAVE my life, how could insurance companies not know this? All this documentation and proof we have to have just to get approved. It's insane!! I was denied last week by Aetna because they said I did not provide proof that I have been morbidly obese for 5+ years. Basically they had 2000-2004 data, but not 1999. Why didn't the insurance person at my surgeon's office get that from me BEFORE sending my stuff to Aetna? I mean, this is her JOB, she gets paid to make sure all the t-s are cross and i's are dotted. She missed one year on my life and caused me a wrongful denial. Anyway, I basically had a breakdown on the phone with her about it and she said that normally they don't do appeals, but she would do mine because it was basically her fault. My gosh. And it takes more than just a phone call to Aetna to fix it, she has to redo all the precertification, etc. I'm like, why is it so hard?! This is insane! Insurance companies make things SOOOOOO difficult. Basically all she has to do is fax a dr's record from 1999 and that's all they need. But nope, she has to redo everything and re-fax everything to them. Insane. So I'm holding steady. I know in God's time I'll find out if he wants me to have this surgery or not. I'm sure hoping it's a yes!! But that's where I am for now. Thanks to everyone for their awesome posts and e-mails last week when I was basically a wreck when typing my "i was denied" post. Ugh!! So glad I am not alone in all this. God Bless, Trisha in Phoenix

Trish, You're right about that. The insurance company wants you to jump through hoops because they don't want to pay for the surgery if it can be avoided. It's unfortunate because many of us are suffering with high blood pressure, diabetes, etc., and would probably die without surgical intervention. I had my surgery on January 13th, finally after three years of trying to get approved for surgery. I would either have the wrong insurance or I would be laid off. Finally, I work for a company that believes in this surgery. My thoughts will be with you for a speedy approval. Randi

Insurance companies don't seem to care what is best for the patient. They only seem to look at the initial costs. I am really concerned about my approval (which I am waiting on). When I had my consult with Dr Juarez I asked him point blank about my insurance company. I asked if he thought I would have any problems. He said he could not tell me for sure what they would do, I have Arizona Foundation for Medical Care, but he said if I had Aetna or Pacificare it would be really hard at best to get it approved. Apparently Aetna has decided they do not want to do this procedure at all. I don't understand this mentality.... Would they rather put out some money now or have high medical expenses for years. Have faith. You may have to fight but it will be worth it in the long run. I will keep you in my thoughts. Gretchen

When I was fighting with Cigna (which I switched insurance to get approved), I was told the reason why some insurances do not look at it will cost them less in the end is beacause majority of us are with a particular ins co for olny a year or so. So why would they want to fork out $25k+ for someone that will only be on their plan for a year or two? Bottom line is ins co's do not give a flying f... about our health. They want to make money on us. Just look at how much $$ Cigna made in the past. It took me 23 months AND byt the grace of God, changing insurance co's to get approved. Every time I pass a Cigna building, I want to blow it up for the way they treat people on this issue.