Question:
I contacted my insurance an dteh denied me the I have Bc/bs
— lovely43 (posted on November 16, 2007)
November 16, 2007
I'm so sorry they denied you. What reason did they give? Did you have the 6
mo supervised weightloss documentation and all your records in order? Was
it even a covered benefit on your policy? You can and should appeal if it
is a covered benefit. Good luck, and don't give up without a fight!
— juliebelle0402
November 16, 2007
Hi,
Keep trying. It took me two years to get approved.
I was denied twice WITH all of my documentation.
Every month after the first denial, I would go back to my pcp and get it
documented of everything that was wrong with me and so forth.
After pages and pages were sent to the insurance, I was finally approved.
I also have BC/BS.
Good Luck and Yes, do not give up!
— oliviamorris
November 16, 2007
I have bcbs, what were the reasons they did not approve the surgery. I was
lucky to get approved right away but I did have to have a ton of
documentation and I have several medical problems that would save the
insurance company a ton of money in the long run. I did have to have the
six month weigh in and tons of other tested. Keep trying and go back to
your doctor to see if you missed any of the criteria. I would also write to
the insurance company with an appeal. Good Luck.
— ednamjr
November 16, 2007
Yeah - they kinda stink. Well, in some parts of the country, through some
employers, they totally rock. In my part of the country, through my
husband's employer - they totally stink when it comes to covering WLS.
Went through the whole submit, get denied, resubmit, get denied again -
with two insurance companies! Then went to an attorney who specializes in
fighting this sort of thing - who told me it was a hopeless situation - our
particular coverage simply has nothing to be fought successfully in court.
So - I self paid for my surgery.
It was impossible, pretty much... We didn't have two dimes to rub
together, but then a miracle (and I mean that in every sense of the word!)
- someone anonymously donated the money for my surgery into my surgery bank
account. I know now that it was someone from my church - just not who.
But it was a miracle nonetheless, and I am SO thankful to this day for
God's amazing grace to me.
I gotta say - I thought going through the whole insurance nightmare was a
horrible thing. BUT, I consider it a blessing now because it really made
me take ownership for my need to pursue surgery, find the surgery that I
knew I could be successful with long-term, and the surgeon that I felt most
comfortable with risking my life with. (I was a horrible surgical risk -
my PCP had told me that I likely had less than 6 months left to live; in
fact, she doubted I'd live through surgery. I'm so glad she was wrong!
:))
Don't give up - it's worth the fight!
Blessings,
dina
— Dina McBride
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