Question:
Has anyone been denied by their insurance company and been afraid to pursue it

   — Julia T. (posted on July 11, 2002)

July 11, 2002
I am sorta in the same position as you. However, I was denied 3 times already, even with 4 drs. saying I really need it. So, I have contacted Walter Lindstrom and talked with his wife. She was very helpful and answered some questions I had. I decided to pursue this with them. I feel comfortable with it. It wouldn't hurt to just talk to them.
   — Pat R.

July 11, 2002
I am sooo glad to know that i'm not the only one in this situation,even though it really does stink!!! My situation is slightly different then yours,but I also don't know how to go about persueing anything.I have been in close contact with a few doctors and a group of people that are bringing the WLS to the hospital that I currently work at.I had planned on having the surgery elsewhere before all of this came about,then I was asked to wait and be one of the first patients/employees to have the WLS here.That way I could help bring in more patients.The thing is,I was planning to have the surgery in early october,and today our insur company decides that they aren't going to cover it anymore.They said check back in 6 months after they revise their policy to see what they decide to include in it.So is this the same as being denied,I mean is there anything I can do or am I pretty much stuck at square one again??!!I am so frustrated I could cry!!! any suggestions would be appreciated!!!
   — kim M.

July 11, 2002
Hi, I"m in the same postion also have been turned down 2 outside Dr's say I need the surgery than 2 of the INS Co Dr's say I need the surgery but still said no so I got my Lawyer involved init. DONT JUST GIVE UP FIGHT FOR IT SEENS THEY ASKED YOU TO WAIT AND HAVE IT AT THERE HOSPITAL.YOU WOULD THINK THEY WANT YOU TO BE HEALTHIER TO WORK THERE FOR THEM!
   — Margaret Smith

July 11, 2002
Hi Julia. I'm so sorry to hear of your troubles. (I am now awaiting an answer from my insurance company.) Does it state in your insurance paperwork anything about MORBID obesity? I know that in mine it goes on and on about how they will not pay for anything that is involved in treating obesity, but they will for morbid obesity. If this is the case, you need to make sure that your doctors are coding correctly (for morbid not simply obesity). Sad to say, but if there is nothing about morbid obesity, it seems a losing battle. Is there anyway you can either get a part-time job or change jobs? I know that is easier said than done, but if you want WLS as much as I do, you may want to consider it. I would hate for your (and/or your husbands) life to be turned upside-down because of a jerk of a boss. Please don't give up, but personally, I don't think you can sue and get anywhere if there is a definate exclusion in your policy. I hope I am wrong. It couldn't hurt to contact Mr. Linstrom. He would know better than anyone. Take care, Sweetie.
   — karmiausnic