Hello family haven't posted in awhile just an update

sexysweetsweet69
on 9/2/05 8:44 am - Milwaukee, WI
Well my journey started out 05/2004 , got denied after all pretesting was done 07/2004, had a grievance meeting 12/2004 denied , went to the insurance commissioner 05/2005 denied. My exclusion say any treatment to reduce obesity not limited to surgical proceedures. I weight 424 pounds super super morbid obese bmi 72. I have the follow medical conditions. Severe sleep apnea , lung restrictive diease, severe lower and upper back problem , heart valve leakage, edma, plantar fiatiss(not sure im spelling that right) asthma, mitral regurduatation, gerd, stress incontince, contantly fighting rashes from excess skin, shortness of breath. I fall the sleep behind the wheel of the car due to sleep apnea. After I was denied with insurance commissioner I decided since my company is self fund, I put the ball in there hand, I have been employed with my company for 10 years, we have a high turn out rate of 98%, my company is self funded I wanted my company to deny me. Not humana not the insurance commissioner, I wanted them to tell me no. I had my doctor redo my medical necessity letter, and make it as a official notice to the company and the person who was handling the internal appeal. So I talked to hr lady who told me that I could do an internal appeal. The internal appeal was recieved by my company 8/4/05 . I have since had to be rushed from work by ambulance , first time power outage electric was out , couldnt use the elevator. boss made me walk up two flights of stair , i couldn't breath afterwards, ambulance was called to take me to emergency room. Second incident happened 08/31 my boss was spraying perfume by me some went in my face I swallow some which went in my lungs to started tighten and I got short of breath. I was rushed to the emergency room from work again. I am now waiting for my employer to make a desicison. On what they are going to do. with my appeal. I also have 2 copy of certificates of coverage. MY coverage started 5/2001, I recevd a certificate of coverage dated 02/2003. Different policy that say they would cover if morbidly. SO I AM STILL WAITING i AM GOING TO GIVE THEM A MONTH THEN I am getting me an attorney.
Brandi
on 9/2/05 12:30 pm - TX
Wow!! You have had a ride! Looks like I am right behind you. With your persistance you will have this surgery done. Good Luck! Brandi
CuteDonna
on 9/3/05 2:31 am - Effort, PA
YOU GO GIRL!! Don't you give up and keep fighting the SOB's. You have been fighting this for a very long time and they want you to give up but let them see that your will is stronger then theirs I had to fight also but nothing like you so I to you for being stronger then them. Keep us posted. Donna 338/185
AJSkinnygrl
on 9/19/05 4:08 pm - Los Angeles, CA
Hey Sherry, I'm new to this message board. I'm trying to get approved with Cigna PPO in CA. I've had drama but I can't believe your insurance will not approve you! Girl, get an attorney!!!! They cannot continue to do this to you!!! You are intitled to better health!! Don't let them get away with this!!!! I will be praying for you Please keep in touch and let us know things are going AJ
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