Please help!

Karen P.
on 9/20/03 1:38 pm - Longview, TX
I am fed up with my insurance! I have been trying for 2 years to have the stomach stapling surgery. My doctor has also recommended this sugery and has written a letter to my insurance company. I have many health problems due to my obesity and I hate being over wieght. I am ready to have this surgery! The problem is something different everytime I am getting closer to having the surgery. My insurance is Covenant Administrators and they will cover the surgery but MediCor has the intial first say and the authority to nip it. I asked Medicor specifically what I needed to do, well I have almost done everything. I only need to attend classes with a nutrionist. I was planning on doing this and having the surgery in SHreveport, La in December. I have met all deductibles and this would be covered at 100 %. This is why they are dragging this out. I recently receved a letter from Medicor stating now that I would have to attend classes for 6 months. I have a letter from Medicor that does not have this information on it, just says to visit with a nutrionist and have all my medical records faxred to them. Which I did. They add something more to my list of to do's after I think I am almost done before they will authorize the surgery. I work with a lady in my office that had this same surgery two years ago and she never had to do any of the requirements that I am being forced to do! This angers me and is is so unfair! SHe is is the one encouraging me to have this surgery and she has been very successful at loosinf weight. She had fewer health problems than I have. I do not want to wait another 6 months. I will attend a class, just because I am being forced to, but I want to have to have this surgery in December while I am off. I am a sinlge parent and do not have much money and will never be able to afford this surgery again. Please help, this is so unfair. If my insurance says they will cover this and my dr has recommended it, why isn't that good enough? Medicor information: Donna Ribbler, RN CCM 1-877-253-5523 ext 8415 or www.medicor.org I feel abused by the insurance company! Thanks so much for any help! Karen Patterson LeTourneau University Longview, Texas
Bronxgirl
on 9/21/03 10:54 pm - bronx, NY
Hi Karen! I understand how you feel...I was also mistreated by my insurance company...I luckily just won my appeal, but it wasn't an easy battle...You're going to have to follow exactly, word for word, what your insurance company is asking for...It's the only way to get yourself approved...It's just a big game, I know, but you gotta do it...Or, maybe try a lawyer...
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