Question:
What if I type a letter to my insurance company?

Alright. I have typed up my weight loss history and now I am ready to fax it to the insurance company. My question is do you think it will hurt if I type a letter and state to them why i think this surgery will be beneficial to me?    — Sonya P. (posted on June 10, 2003)


June 10, 2003
Do you have a surgeon, PCP, family doctor, etc working with your insurance already? Or are you trying to get "pre-approved" on your own before seeing a surgeon? Sorry, I'm not sure where you are in the process of everything... my thought would be if you aren't working with a doctor yet don't do *anything* you could seriously hinder your doctors abilities to get you approved quickly. If you are working with a doctor, I would suggest giving them the list you have and allowing them to type it up as part of their package to have insurance review it. But again, I don't know where you are in the whole process. I wish you lots of luck! =) ~ Kim ~
   — Kimberly J.

June 10, 2003
I am in the process of being approved or not approved through my surgeon's office. They are corresponding with the insurance company on my behalf, but now I need a diet history submitted also. My PCP has already written a letter on my behalf as well as my surgeon.
   — Sonya P.

June 10, 2003
Working for an insurance company, and knowing how they look at things, I would suggest that the more information they receive, the better. HOWEVER, they are not interested in your 'quality of life' or how you feel about yourself, sorry to say. They don't care if your clothes fit or if you have a hard time finding clothes to fit, or if you're embarassed because of your weight. What they WILL respond to is techincal, medical information regarding your health and cormorbites. THAT'S what they're interested in. Good luck!
   — scottiemaam O.

June 10, 2003
I sent my insurance information and letters every day. I think I was approved so they could get rid of me! HA! Well, I was very proactive in getting my approval-read my profile for more. Good luck!
   — TP

June 10, 2003
Scottiemaam is right - the insurance company does not care about your quality of life - to some extent. If you can write down how having this surgery is beneficial to you AND the insurance company - you might be okay. In other words, if you explain how your co-morbidities will cost the insurance company more down the road, that would help. I would not send a diet or weight loss history or any other information on my own. Hold off until after your surgeon sends in his request for authorization.
   — koogy

June 10, 2003
This is one of the things that my surgeon had me do, not sure whether it helped with the approval or not. I don't think it would hurt, though. I am 8 months post-op now, and I recently e-mailed my insurance company to tell them thank you for covering my surgery and what a difference it has made in my life. I got a very nice personal e-mail back from them. I think all post-ops should do that--it could only help those seeking approval.
   — Want2bslim

June 10, 2003
I agree, skip the "quality" of life stuff and go for how your weight "impacts" your ability to work, move etc. How your documented diet history shows that your weight would probably increase and over time you could cost them even more in medical care. I wrote a similar letter to my insurance company. I was approved in only a few days and was told that the letter was an influential factor in their decision.
   — M B.

June 10, 2003
I wrote 2 letters to my carrier and they didn't respond. I feel as though they never read either of them. I finally have hired an attorney to get them straight. I was denied by they did not have supporting documents of my cormorbites. My sleep doctor has now wrote a letter on my behalf stating that I have Obstructive Sleep Apnea Syndrone and losing 80 plus pounds would benefit me and that he felt that I was a good candidate for Gastric Bypass. I belive if you can work with your PCP or other doctor to get you approved it would be more beneficial than what you desire to tell them. I believe they all must be "SKINNY MINNIE'S" and they just don't understand. After that being said I wish you the BEST OF LUCK and most of all may God Bless you.
   — CINDY D.

June 12, 2003
I do think it will help if you write a letter to your insurance company. When I filed for surgery at the age of 17, I wrote a letter to my insurance company, explaining how my weight resricted me from doing so much. The letter was kind of rude and to the point, but it was sophisticated, and big words which they like to here, to really see if you know what you are talking about. The reason I wrote this letter is because the insurance company was giving me the cold shoulder. My grnadmother took this letter and faxed a copy to everyone she could get a fax number to at Aetna. With in 20 minutes I got a personal phone call, asking me what the problem was, why I hadn't been helped, and how they could assist me with anything I needed. After this call I then had a personal claims person who dealt with my claim and kept me informed on what was going on. Yes a letter is helpful, but why be rude if it is just part of the procedure. If your doctor or insurance company wants a letter, write one, but remember the people who are looking at it do not know you and to them you are just a number and a piece of paper. So write a letter stating your disabilities due to your weight, and best of all send a picture, it could be old or new, but where you look the biggest in your life you have ever been and that will sure get their attention. A picture is worth a million words.
   — Saleen98




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