Insurance, Cash Pay and Financing

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Walter Lindstrom
on 9/25/12 1:53 pm - Chula Vista, CA

Topic: Appealing an Aetna denial - another happy ending

I wanted to share the link to our latest blog describing another Aetna denial (lack of a 2 year history of morbid obesity) which we got overturned....hopefully it helps someone needing it!
wlsappeals.com/winning-bariatric-surgery-insurance-appeals/

Walter Lindstrom, Jr.
[email protected]
LINDSTROM OBESITY ADVOCACY
WWW.WLSAPPEALS.COM, 1-877-99-APPEAL

jk2012
on 9/20/12 6:57 pm

Topic: Wellmark

Anyone have Wellmark? Have you been approved/denied recently? Just curious if you submitted years of records with weights in addition to the 6 month physician supervised diet? I am getting conflicting information if this is required or not. As you probably know, Wellmark will not tell you the requirements. They say your doctor will know what they are. Any info of the requirements would be great!

Theresa-Wehby
on 9/19/12 11:36 am - Birmingham, AL

Topic: BC/BS of Alabama

Well I just need information. I have been fighting an exclusion on my policy. I have submitted letters from all my doctors along with my personal letter. In addition my employer also requested that they lift and or set aside exclusion to allow me to have this surgery upon medical need. Last Friday I went in person to get an answer from BC/BS. I was informed that it was denied. Now I want to appeal decsion and since I am doing this on my own, I need any input you all could give me. It is like I told them that you now cover my eyes and it is excluded but you cover now cause I am a diabetic. This is same princpal here, I am very frustrated in the play on words that they use to deter you from appealing etc... I have been working on this and it is imperative I get this procedure done. My doctors tell me that I will lose the use of insulin and since I am insulin resistant. I am on this huge ****tail of insulins to just keep it in check. I could go on and on with issues. Any advise on my approach from here and how I may get this accomplished it would be greatly appreciated.

amandawood1978
on 9/18/12 6:27 am

Topic: RE: Insurance won't cover so I need $25,000

Thanks for getting back with me. I just called them. The sleeve is $16,000. They allow you to pay 50% up front & then the hospital will set the other half up on 12 months. How I wish I could just finance my surgery here at home.

fairie0025
on 9/17/12 8:05 pm

Topic: RE: Insurance won't cover so I need $25,000

Very recent. I have been saving for the down payment.. Dr. Vaughan is a GREAT doctor... My best friend went to him and also a few other people I know.. Hope this helps.. You can also call them if you have any questions, their number should be on one of these sights.. Or just google Jupiter medical Center in Juiter FL..

These might help you..
http://www.jupitermed.com/bariatric

http://www.jupiterweightloss.com/Seminar.htm

On this one, go to the 5th question it will help..
http://www.jupiterweightloss.com/FAQs.htm

amandawood1978
on 9/17/12 4:28 pm

Topic: IN-HOUSE FINANCING

I am wanting to have the sleeve or lapband. I have been denied through Care Credit. Does anyone know of any doctors providing in-house financing with down payment??

amandawood1978
on 9/17/12 4:25 pm

Topic: RE: Insurance won't cover so I need $25,000

I was just wondering how recently you heard of the place in FL. I have been searching for someone that would do in-house financing with a down pymt. It would be soooo awesome if it worked out for me!

marceemarc
on 9/17/12 2:56 pm - Graham, NC

RNY on 04/21/10

Topic: RE: One surgery, per lifetime HELP!

Coming from an insurance background, I hate to say that your hands are pretty much tied. Without a hard fight ahead I dont know that you can do it. Is there any hope of getting switched to someone elses policy with a different carrier? Maybe contacting the Dept of Insurance for your state.

Keep a smile on your face....it makes people wonder what you are up to!