Denied!!
Don't worry (I know that is easier to say than do!!) but my BMI was in the 70's and I was originally denied. Kaye was great and a lot of help... my first appeal reversed the denial and my insurance covered my surgery.
The rules are not right, and the insurance companies need to re-think their coverage for WLS. But there is one possibility that might help you. My insurance company only allowed 2 appeals. So after my first denial, while I was waiting for the appeal to be decided, I found a lawyer who specialized in this kind of thing. A friend of my sister's used this firm successfully to get her insurance company to change their decision. I know that people don't usually like to use lawyers, but there are times when it is necessary. These people charge a resonable fee (considering the cost of the surgery!) and have been sucessful! Their website address is:
http://www.obesitylaw.com/index.php
Stick with it! If we all work together to fight for our right to health, this can only help those in the future!! Statistics show that covering the surgery is cheaper for an insurance company then paying the long-term costs of all the health problems that result from weight issues. One day, they will get smart!
Good luck!
The rules are not right, and the insurance companies need to re-think their coverage for WLS. But there is one possibility that might help you. My insurance company only allowed 2 appeals. So after my first denial, while I was waiting for the appeal to be decided, I found a lawyer who specialized in this kind of thing. A friend of my sister's used this firm successfully to get her insurance company to change their decision. I know that people don't usually like to use lawyers, but there are times when it is necessary. These people charge a resonable fee (considering the cost of the surgery!) and have been sucessful! Their website address is:
http://www.obesitylaw.com/index.php
Stick with it! If we all work together to fight for our right to health, this can only help those in the future!! Statistics show that covering the surgery is cheaper for an insurance company then paying the long-term costs of all the health problems that result from weight issues. One day, they will get smart!
Good luck!
Wait until you get their letter, which will spell out what they need. This happened to me and I was livid and depressed. When I talked to Kay she said that they had already sent the required paperwork, but will resend the "missing" forms. She faxed the forms and within the same week I was approved. I know it stinks but be patient and pester that insurance company every day!!!
~~SARA
~M
~M
You must do the thing which you think you cannot do.
~~Eleanor Roosevelt
You must do the thing which you think you cannot do.
~~Eleanor Roosevelt
Most Active
Recent Topics
WooHoo! It's that time again! Early Bird Tickets Now On Sale, Save $25!
Kathy S. · 0 replies · 2648 views
Kathy S. · 0 replies · 2648 views
