I need revision
Medical necessity doesn't mean anything. If it is excluded it is excluded. They are not telling you that you can't have surgery, they are just saying they are not going to pay for it.
Some ins co's exclude organ transplants. You can't get any more "medically necessary" than that and they still aren't going to pay.
How did you get your sleeve? Self pay?
I do not believe anyone is trying to discourage her. She asked for advice and a lot of us have gone through extensive insurance as well as legal means in pursuit to receive weight loss surgery . I never would try to discourage someone as I come here every single day to try to encourage people not to give up and to help those that are in the same boat I used to be in. Yes all insurance companies are different . However, if there is an "exclusion in their policy" they will not pay for weight loss surgery . PERIOD! Unless you have any information otherwise from your own experience to share that contradicts what we have shared with her.
I think this is what you meant to say....
" Don't let some of these SELF PROCLAIMED, KNOW it all " ?????
Banded 6/9/09 HW 242 LW 142 Revision 198 m 1 loss 16 lbs 182. M 2 loss 4 lbs 178. M3 loss 6 lbs 174.m4 loss 4 lbs 168. M5 gain 2 lbs 170. M6 loss 7 lbs 163 M7 loss 5 lbs 159 M8 loss 1 lb 158 M9 loss 0 M10 155 loss 3 M11 154 loss 1 M12 loss 2 152 M13 loss 3 149 M16, 17 0 loss M 18 loss 4 lbs 145 (18 months 53 lbs)
Well I guess " hot chic" deleted her rude message so mine doesn't really make sense but oh well
Banded 6/9/09 HW 242 LW 142 Revision 198 m 1 loss 16 lbs 182. M 2 loss 4 lbs 178. M3 loss 6 lbs 174.m4 loss 4 lbs 168. M5 gain 2 lbs 170. M6 loss 7 lbs 163 M7 loss 5 lbs 159 M8 loss 1 lb 158 M9 loss 0 M10 155 loss 3 M11 154 loss 1 M12 loss 2 152 M13 loss 3 149 M16, 17 0 loss M 18 loss 4 lbs 145 (18 months 53 lbs)
No I can still see it. I did not find that anyone was being a "know it all". I asked for advice and that is what I am getting. I am still hoping that there is some way around insurance as I wouldn't qualify for WLS now but I know it is a long shot! I am a nurse at the hospital so I am hoping for a discount I will find out tomorrow. I am so stressed about all of this. My reflux is terrible I do not want to be miserable forever! I love my sleeve it is a great tool but this reflux is not for me!!!