Denied

I have Medical Mutual of Ohio (SuperMed Plus) and I got a call today from Rena at the Barix Insurance office. She said that they had received a letter from my insurance company saying that I was denied , she said that she was going to call them back and see why they deemed it not medically necessary. She thinks it's because my BMI wasn't 40. It's 37. I have chronic back problems, swollen ankles, I don't sleep well, I usually wake up tired. And I think after today I can add depression to the list. I just went out back and cried. I don't know what to do. I tried to call, but MMO never answers their phone and you leave a message and they don't call back. This is such a big let down. Thanks to everyone for listening, I don't really have anyone to talk to, I've been trying to keep this quiet till I know for sure or not. My family knows, but I don't really say anything about it to them. Thanks, Tami Columbus

So sorry to hear about your denial, I to was denied a couple of weeks ago from highmark BCBS. I did the same, cried for a while and vented about how I was never going to be thin and happy and healthy,but tomarrow brings a new day. I am going to fight, and I hope you will too. I know it is discouraging, but I know the good lord will make it happen for us. I'll keep you in my prayers and good luck. You can talk to me anytime...

Thank you Shonda for the kind words. I hope that everything works out for you.

tami...i have med mutual and i went to barix--don't give up! yes , your lower BMI is probly why they denied you- however, many ins companies seem to deny on first go round .... you say that you don't sleep well and wake up tired-have you been tested for sleep apnea??????? i am surprised that a barix doc wouldn't suggest that--and the apnea can make their decision get reversed. if you really believe that this surgery can help you get healthier-do NOT give up!!!! the appeal process makes no sense the way it is done- but you can appeal!!! email me privately if you wish!i listen well.... fight the good fight!

Oh Tami, I feel for you greatly, I also have the same insurance and I am waiting on approval. However, my BMI is 49.4. Now I am nervous more than ever, It seems that this type of insurance has been handing out so many denial letters lately. It is so hard to be optimistic about this. My prayers are with you and you Appeal it to the end!! God Bless Jackie C.

hi tami, i also have medical mutual and was denied recently. i have an appeal in the works now, but dont hold much faith in it, my denial was due to not enough non surgical documentation, they want one year of diets in a row. The sad part is that my bmi is 51 and i have diabetes, acid reflux, asthma, suspected sleep apnea, chronic back pain and depression, and high blood pressure. what more do they want? ill keep fightin them , you do the same.

Wow, What is up with Medical Mutual? Stacie,I feel for you. It is not fair that they take our lives in their hands. I have to admit, that so far I have had good repor with one person @ medical mutual. She is pretty informative when I need to know something. However, she is not AAH, the people who send the verdict. You keep fighting and dont ever give up. Hopefully we can stay in contact and see how this turns out,, You have my prayers Jackie C.

i needed that today! thanks so much

Your very much welcome Stacie, and If ever you need a large shoulder : ) feel free email me anytime.. God Bless Jackie C.

I'm so sorry to hear about your problems. Hang in there! If you truly believe this is what you need to do, don't give up! Is it possible to switch insurance companies for 2005 to a company that provides the service? At any rate - don't give up! You need support, so if you don't feel you can talk to your family about it, really find someone either on here or a really close friend that you can talk to - the talking really helps - especially with someone that has gone through a similar situation. Take care and I'll be praying for you!