Very Frustrated

I talked to my doctors and went through all of the required steps. I recently got a letter back from insurance saying I was denied, and could not have the surgery. So now I am having to go through appealing their decision.I am not even sure how to go about it. On the paperwork sent to my insurance company it stated that I was a medium built woman, and in fact I am a small built woman. So based on me being a medium built woman I did not meet the insurances standards. It is becoming very frustrating and I'm getting a little discouraged. I was just wondering if any one else went through this to!?! Would love to hear all of your experience. Bobbie from Clarksville

Bobbie, I'm so sorry that it's not going well for you....I was denied also :[email protected] did not appeal! I went and got a loan, I told myself that I'm worth it and I was sick of my insurance giving me the run around :argue: after I did everything they told me I needed to do. I had all 6 of my doctors tell them this is a life saving thing I need!( yes I have 6 doctors) Sorry I'm not much help but I wanted you to know how it went for me. I will put you on my prayer list and I really hope that things will work out for you... :angel: Christy

i'm so sorry to hear this, but I would encourage you to appeal. I have seen MANY people on this site be denied at first, and then win on the 1st, or even 2nd appeal.... I would try this before considering a loan...I will pray for you!!! Luv, Jacqueline

Thank you for encouragement! I am working on my appeal now. It is hard when you get bad news but all of the support I am recieving is helping me get through this. I hope the appeal works on the first try but I will not give up the surgery is to important to me. Thank you for your prayers it means a lot. I hope you are doing well. God Bless Bobbie

Hey thanks for your concern. My husband served 30 years in the army, and most of the people I have talked to with TriCare have had no problem. I think my main problem is just the mix up with me being a small framed woman and not a medium framed. I am going to keep on trying though I am not easy to get rid of when I really want something ask my husband But again thank you for all your support and advice and God Bless! Bobbie

Hello Bobbie. I was denied the first time Sept. 2005 by my insurance company. I followed their guidelines and did a 6 month dr supervised diet. Then I was denied again April 2006. I had my pcp write a 2 page letter and appeal the second denial. I gat a letter stating they were going to do a hearing and I could listen in and they may ask questions. The day of the hearing, May 31, I got an email stating I was approved. I started to give up after the second denial but i thought all they can say is no again. I would keep trying before I got a loan also. Don't give up and keep praying about it. Last September my PCP said that he was praying for me and he had already claimed that I will have my surgery by the summer and he was right. Call your insurance company with your concerns.

I am sorry to hear you had to appeal yours so many times. That must have been frustrating. I hope that my appeal works out. I am waiting on a letter from my PCP now, and i wrote a letter too so i will send both of those letters in at the same time. I am glad you did give up after your second denial I know how this surgery can change lives. I hope all is well with you, and thank you for your advice. As much as I hate to hear all the denials you went through it is nice to hear that other people went through this and that ended good. God Bless you and thank you again. Bobbie

Bobbie, I never had to get approval as I have medicare/medicade, my problem was being denied by 11 surgeons. I found out last year I have leukemia, it didn't stop me from still trying. My blood tests came back, and Dr. Colquitt did my surgery after three years of trying. That was in Jan. 06, I have lost 99 lbs to date. Don't give up, or give in, fight for your right to a healthier you and a better life. Appeal, appeal, appeal. Most insurance companies will deny you the first and sometimes the second time, your surgeon and Dr.'s will work for you to appeal the insurance. You can do this. I have enough faith to know you will get your surgery, but you have to be willing to keep your head held high and fight them. Get a loan as the last result. Is there an exclusion in your policy that says they will not cover any form of weightloss surgery? Find out. Then go from there. May God travel with you on your new journey, trust him, and don't get frustrated. Always, Kathy

I really sorry to hear about your leukemia. It had to have been hard to find out something like that. My grandmother and father-in-law both had cancer. It was a very difficult time in my life and on my whole familie . My family is praying for you. I am really glad that you got to have surgery I am sure that was very important to you. I am beginning to realize that this is a hard road to travel with finding the right surgeon, getting the funds to have the surgery (whether it be your insurance or loans), and then post-op. But I wish you the best of luck and God Bless you! Bobbie

Please keep trying. My first visit to the surgeon was on Feb 9. I too received a letter from my insurance company requesting additional information and testing. I jumped through all their hoops and sent them a letter of my own outlining how miserable I was with my weight and how it was affecting me medically otherwise ( blood sugar, blood pressure, swelling in my feet. etc.) Within just a few weeks I received a letter of approval and I had my surgery 3 weeks ago. Don't give up!!!