Getting ur teen approved????

dawn88
on 4/21/12 7:36 am - OH
Long story short my teen is 14 and in desperated need of wls. her medical history is well documented, the issue is insurance says she needs to be 18, has anyone found away to beat this rule, please help, we are desparate!!!! thank you in advance.
Ashley O.
on 4/22/12 11:08 pm
I think you messaged me on facebook a couple days ago about this, but I thought i'd respond here aswell incase anyone else sees this.

I know lots of people have fought insurance, some lost, others won.. I think it helps if your in a program specificaly for teenagers. I"m not 100% sure, just from what i've read up it seems like an easier process. if you have a surgeon that will operate on her at 14, just go through their office and continue appealing the denial.. eventually they may just get tired and approve it to get everyone to shut up. do the medical necessity thiing, submit all paperwork, work with the surgeons office and maybe even write a letter askign..

Sometimes it just wont be covedred though.. it may not be in your plan.. and a lot of insurers have a problem with minors recieving wls.. and theres just nothing youc an do about it, unforutnatley. /:

I hope it all works out for you and your daughter. feel free tomessage me if you have any other questions or concerns. (:

-ashley

"Be kinder than necessary, for everyone is fighting some kind of battle."
~

Check out my blog? (: www.ourfightnow.net
~
          

Tom Inge, MD
on 7/1/13 8:05 am - DENVER, CO
Hi Dawn,
Ashley is right, there are policies that have surgery as a covered benefit and others that do not. And even if it is a covered benefit for an adult, they will deny children, especially if they are not yet sick enough. I know, it is frustrating.

At 14, it will be difficult to find a surgeon and it is likely that a dedicated pediatric WLS program would be in your best interest.

Feel free to send me more details if you would like to at my hospital email account and I can perhaps give some more feedback.

[email protected]

Thomas Inge, MD, PhD, Professor of Surgery and Pediatrics

Director, Adolescent Metabolic and Bariatric Surgery (www.childrenscolorado.org/bariatric)

Principal Investigator, Teen-LABS (www.Teen-LABS.org)

Children's Hospital Colorado and University of Colorado, Denver

[email protected]

Executive Assistant:

Karen Warnock

Phone: (720) 777-3179

[email protected]

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