Too good to be true

I called my insurance today and they said that my claim was denied because I don't have 5 years of medically supervised weight loss and that my BMI is not 2 1/2 times something...she kind of lost me after DENIED. She did say something about I didn't have enough co-morbidities or something. I only have sleep apnea and a bad back, not good enough for them. So I doubt that I'll be back here. Thanks for all the help and advice, it's been fun.

Tami, I tried to get this surgery done in 1999. I was denied. I just stopped trying and ended up with all kinds of health problems. You can do a appeal. I am sorry about your deinal. Insurance companys can be very uncaring. Dont give up all hope. Take Care Barb

Aww, that is really upsetting Tami. Please don't give up this easily. You can appeal. You may discover something you forgot to add. I started going to the doctor for every little thing so there was a record of it. Sleep apnea should be a strong enough co-morbidity. do you have receipts from joining weigh****chers, diet centers fittness clubs things like that???They probably want your BMI to be 2 times your healthy weight as determined by the 1960's charts. If anything, you don't need to feel like you can't be a part of this online community becuase of a denial. We still like you and want you around. Keep your chin up and keep fighting. Maybe the key to overturning the denial is right here and if you walk away you will never know about it. Hugs, Jaimee

Tami, Honey, I will help you through this! I appealed three levels and won on the third appeal. You do have five years of medically documented weight loss if you went to the ob-gyn for your annual visit. They weighed you each time you went. And I'm sure your ob-gyn said each year that you needed to drop some pounds. E-mail me or call 419-668-1201 and we can talk. There are letters to write from your doctors supporting why this surgery is medically necessary for you. The "Insurance troubles" in the section of "Your Journey" on this website helped me. I'm rooting for you, and when we exhaust all appeals we will use the Ohio Insurance Commision complaint form and give the AMA definition of qualifications to determine WLS. Just let me try, OK? Luann

Hi Tami. I am sorry about your denial. I just had surgery 4 weeks ago with OSU here in Columbus. I was required by my insurance company to do a class called Living Well. One of the ladies in my class had Medical Mutual and was denied at first. She then worked with OSU and was able to get approved. OSU is very good about knowing what each insurance company requires and having all of their ducks in a row befoer they submit. I would recommend contacting them before you give up. It is a battle that is worth fighting. You have to jump through a million hoops but it is soooo worth it. Good luck! Shellie

((((((((((((((((((((((((((((TAMI)))))))))))))))))))))))))))) PLEASE..........DONT GIVE UP!!!!! I went through 3 insurance companies and waited 5 years, but it FINALLY happened for me on May 23rd. My new ins. kicked in on April 1 and I was approved April 11th. I wasted no time trying to get approval. There are other options, just keep your head up and keep trying!!!!! I just checked your insurance and they were the 1st company I had to deal with and I hated it. They denied me too. Good Luck~~~ Carmella

Don't give up girl! It is time for you to take charge of this situation. Write a letter and fax it to your insurance company every single day until they give you this surgery! Call every day,write every day and request this surgery every single day. I am rooting for you!

Tami, The last thing you want to do is stop coming to this website. If it were not from the support I received from the folks here, I probably would have given up too. I was denied three seperate times and kept appealing. Finally, after close to 2 years I was approved and I am having surgery on Monday...8/29/05. Do not let these insurance companies break your spirit! You have a lot of resources here online at OH and the wonderful members are always willing to help in any way they can. Stay strong, be persistent and you will get that approval! God Bless, Lisa

I want to thank all of you for you support. I was so having a pity party, but I'm feeling a little better. Thank you all so much.

Keep your head up high. You will have your day and it will be just the right time. There is a reason always. Love,Cindy