Denied... and want to quit

DENIED DENIED DENIED DENIED DENIED DENIED I called my insurance company this morning and found out that my appeal for panniculectomy has been denied. My insurance company only allows 1 appeal. I've gone from 276 to 179. I am left with a very DISFIGURING pannus. It hangs 7 inches, completely covers my pubic area,I seem to have lost weight EVERYWHERE but my abdominal area... so I am a 179 pound woman with the stomach of a 276 pound person(carried most of my weight in the abdominal area). Dr. says I have about 23 pounds of excess skin and fat that needs to be removed. I currently a wearing a size 14-16 with this massive pannus I'd probably be wearing at the most a 10.. I had pics. letters of support from my chiropracter, pcp,ob/gyn.ER discharge papers from the ER for back pain with copies of scripts for vicodin and phenergin for pain... along with my own appeal letter... Its so hard to live this life . I am thankful for the 100 pound loss.no more GERD,no more sleep apnea. But still so much pain. rashes, infections, back pain... I am in the same positon I was before wls...I am living the same life, the same pain. They say I can ask for a state hearing... but whats the use if the insurance company said no so will they... I QUIT...So i'll live with the pain, the disfiguring appearance, the discomfort,not being able to be intimate because of it...I can't do this anymore...I am still FAT AND MISERABLE..I'm sorry I'm so sad...I just can't believe they said NO again... LIFE AFTER WLS WAS SUPPOSED TO GET BETTER...if anyone has ANY suggestions please let me know

Tracy, you have come too far to quit now! You have lost a tremendous amount of weight and that was not easy. Send your appeal to the State of Ohio Insurance Board - they are NOT controlled by the insurance companies! I also think there is a law firm, I have seen it mentioned on this website, that specializes in obesity legal advice - maybe they can help. Just my opinion, but ... DON'T give up. You are NOT the same as you were! You have this issue and I am believing for you that it will be taken care of! Best wishes, Kitty B.

Tracy, PLEASE, PLEASE, PLEASE DO NOT GIVE UP!!! I know that you must be so very tired and feeling extremely beat down, but, I also know that it can be the darkest right before you reach the light at the end of the tunnel. We all need to stick together and try to advocate for health benefits and insurance coverage for both weight loss surgery and the much needed plastic surgery that follows. This truly is discrimination!!! Ohio seems to be behind the curve where this is concerned. I fully believe that it is only through determination and pioneering spirits that we can break through the stigma and discrimination that obesity sufferers live with. You are worth the effort!!! You have come too far!!! It sounds like you have an extreme amount of support from the professionals that you have overseeing your care. Who do the insurance companies think they are to decide what is best for you, when your doctors know you better than they could ever hope to!?! I agree with the earlier post's suggestion... that you should appeal this at the State level and perhaps get some legal counsel. I wish I had more to suggest. I am still at the beginning stages of my battles.... currently waiting to hear whether my insurance company is going to approve me or not!!! By listening to what other's have to say, I fully believe that the insurance companies want to try to wear you down in hopes that you'll decide that the battles are not worth the effort. Please hang in there and remember to take it one day at a time. I wish you the best and hope that you find the strength to go on.... Please keep us all informed as to your progress and ask for support when you need it!!! Karen G.

Tracy, Do not give up. I really think that insurance companies expect you to give up. Appeal at the state level and show them you are TOUGH! My insurance company, Aetna turned me down for TT b/c we sent in info with no documentation...they want 3 months of complaints and doctor notes so that is what they will get. Unfortunatley its a paper game with them so keep you chin high and don't go down withou a fight! Karie -119

I thought I heard that OSU has a surgical residence clinic that does PS at a lower rate. Sure you will have residents doing most of the work but some of the best Plastic Surgeon will be there supervising. I could be mistaken on this, but I am pretty sure I saw someone post that they had PS done in Columbus at this place.

Yes Sarah they do. Dr. Gordillo offers this to people who have to pay out of pocket. Unfortunately it is a pay upfront thing. But the rates are awesome. I am in the same boat. Denied. Do you fight or roll over? My panis isn't horrible but my breast tissue is AWFUL! I hate the way it looks, it is uncomfortable to pack that skin in a bra, etc... I think with a tt and mastopexy I would lose about 20 pounds and about 2 or 3 more sizes easily. But my insurance says it's cosmetic. Horse hockey. We know better! So, DON'T GIVE UP!!! Where there's a will there's a way! Good luck! Valerie