Recent Posts

jennlg
on 10/16/13 5:00 am - Nashville, TN
Topic: Boyfriend filed bankruptcy last year, how can he finance surgery? :(
My boyfriend had to file for bankruptcy last year due to losing his job and insurance and then having to have some surgeries and hospital stays. He can't seem to find anyone to give him a loan. Does anyone know how he may be able to do this? Or does anyone know of a surgeon who offers financing through their office, or know how to find one? (not care credit as he doesn't qualify) please help....he really needs this surgery. He has a good job now but his insurance doesn't cover it.

    

uglymouse
on 10/16/13 5:00 am - newnan, GA
Topic: RE: Denied-for the second time

I have nothing but hugs for you. I have UHC, but we don't have to show 3 years of  medically supervised diets. We just need to do 6 months of supervised medical  diet. 

Linda K.
on 10/15/13 1:18 pm - Omaha, NE
Topic: Denied-for the second time

 

Denied by UHC-for the second time and for the same reason.  I don't have 3 years of medically supervised weight Loss under my belt.  I don't understand the denial.  I had a wonderful appeal letter and my doctor wrote to say this would save my life.  But-I am not upset on the denial so much as upset at how they did it.  The first appeal was to be done by a independent doctor in a related field.  You want to know what the doctor's related field was???? Cardiologist and thyroid specialist.   REALLY?????  How related is that????    I am so mad I could spit!!!!  How do I do this second appeal.  I tried to show I had all these years of trying to diet.  I showed on paper I had years of different diets, weight loss products, medications-but no!!!  This insurance states that it has to be 3 years consecutive medical supervised weight loss program.  What do I do???  I can't think, I can't feel anymore.  I am willing and ready for the fight, but I don't know if I will just hear the same answer again.  Anyone else dealt with this?  Any information would be helpful.

Thanks so much

Linda

    

        
Virgie Tschirhart
on 10/15/13 11:06 am - Midwest City, OK
RNY on 12/27/17
Topic: Revision from VSG to RNY - Going to my 1st appointments with Dietician & Psychologist

Hi Everyone,

I am so happy because I'm going to my first consultation with the Dietician and Psychologist tomorrow.  My doctor's office will turn in my packet to BCBS Federal after they receive the reports from these 2 appointments. As far as I know I do have the requirements for the revision.  The doctor is going to submit a medical necessity letter also.  Just thought I'd give you all an update.  

Virgie Tschirhart

Lap Band - 2008, Sleeve - 2009, RYN - 2017

Started Program Weight July 13, 2017 - 194.2

Before Surgery Weight December 27, 2017 - 185.0

Current Weight - February 2018 - 161.0

(deactivated member)
on 10/14/13 2:56 pm
Topic: Since my insurance wont cover for another weight loss surgery, can I switch insurance

Hi peeps,

I had the lap band for 1 year now. Starting to gain weight. Haven't lost weight since 3-4 months ago

My insurance said they won't cover for lap band revision to gastric bypass unless I get huge problem like erosion, slip etc

Therefore, is it possible for me to switch insurance to do gastric bypass or what options do I have?

Lastly what do I do if my insurance now says they don't want to remove my lap band on request?

 

Thanks a lot

hollykim
on 10/13/13 11:06 am - Nashville, TN
Revision on 03/18/15
Topic: RE: Won an APPEAL???
Sorry to say it is virtually impossible to appeal an exclusion and win. Just doesn't happen. I was in the same boat and we saved up ,sold things,borrowed money and everything else we could do and I went to MX for a fraction of the price of self pay in the. uS.

Starbucks,lowes and other places ha e benefits for even their part time people that includes WLS. Maybe a part time job there?
GL

 


          

 

kingtut319
on 10/12/13 7:22 am
Topic: RE: Aetna Appeal Letter

Hello there. I have recently "completed" or so I had thought the necessary requirements from Aetna to be approved for a the gastric sleeve surgery. I finished my classes at Ohio State Medical Center on July 27th. In 2011 and 2012 I did not take any trips to the doctor, I travel for work so because my last visit was in 2010 I was denied due to not having 2 consecutive years of proof of obesity. I was hoping to get some suggestions on what I can do in this situation. Thank you so much for taking the time to read this.

 

Sincerely,

Justin Tuttle

kingtut319
on 10/12/13 7:21 am
Topic: RE: Aetna Appeal Letter

Hello there. I have recently "completed" or so I had thought the necessary requirements from Aetna to be approved for a the gastric sleeve surgery. I finished my classes at Ohio State Medical Center on July 27th. In 2011 and 2012 I did not take any trips to the doctor, I travel for work so because my last visit was in 2010 I was denied due to not having 2 consecutive years of proof of obesity. I was hoping to get some suggestions on what I can do in this situation. Thank you so much for taking the time to read this.

 

Sincerely,

Justin Tuttle

LorraineM2013
on 10/11/13 12:14 pm - Cary, NC
Topic: RE: Won an APPEAL???

I don't have any answer because I am in the same boat.  I am hoping you get some responses here.  

DeeDeeLynne60
on 10/11/13 11:04 am - Massillon, OH
Topic: Won an APPEAL???

Anyone won an appeal after insurance says NO BARIATRIC COVERAGE?? If so where do I begin??

Most Active
×