Will Government step in soon?
RNY on 07/09/12
It's pretty messed up that people who need this surgery cant get it through their insurance companies, EVEN WITH A LETTER OF MEDICAL NECESSITY... When will state and federal regulators step in and start doing something about these insurance companies??? Sorry, just ranting this morning!
(deactivated member)
on 1/1/09 4:33 pm - sunny, CA
on 1/1/09 4:33 pm - sunny, CA
Insurance companies deny because they can. Someone who is the same weight as you, has the same comorbids, same insurance, etc ...could be approved while you are denied. Insurance companies are out to make money, they are a business.
What state do you live in? Some states do have a state agency (I live in CA we have the DMHC, Dept. of Managed Health Care) who oversees HMOs. If you post on your state board maybe someone who's had insurance issues can offer advice on how to appeal, what recourse you have if you exhausted all your appeals etc. I know that there have been some posters who have contacted the insurance comissioner in their state who has helped them get insurance approval or hired an attorney.
I had to fight my insurance for over 5 years to get approval for the DS. If you really want WLS never give up. Find out what your insurance requires, post on your state board and see if others can help you, maybe someone has an appeal letter they can send you. Best of luck to you and remember you're not alone.
What state do you live in? Some states do have a state agency (I live in CA we have the DMHC, Dept. of Managed Health Care) who oversees HMOs. If you post on your state board maybe someone who's had insurance issues can offer advice on how to appeal, what recourse you have if you exhausted all your appeals etc. I know that there have been some posters who have contacted the insurance comissioner in their state who has helped them get insurance approval or hired an attorney.
I had to fight my insurance for over 5 years to get approval for the DS. If you really want WLS never give up. Find out what your insurance requires, post on your state board and see if others can help you, maybe someone has an appeal letter they can send you. Best of luck to you and remember you're not alone.
RNY on 07/09/12
I live in NC, but my Insurance is governed by FLA (BCBS of FLA). Thanks so much for the response to my post. It's very frustrating to fight this insurance red tape!