Need Information

  • Hi everyone,
    I am a 46 year old mom and grandma in need of gastric bypass. I have been denied for the 2nd time by my insurance co. and don't know what else to do. If anyone has had this problem and have answers please answer this plea for help. I have diabetes, high blood pressure, high cholesterol and triglycerides, have thyroid problems and now sleep apnea and restless leg syndrome. Thank you so much to anyone who can offer help.
  • Well, I guess that first thing you have to find out is WHY were you denied??? That's the first step and possibly something that you can remedy by supplying more info to the insurance company. If it's a exclusion then I don't know if there is a way around it. You would probably have to talk to your HR dept and see if they can work with you. I do know that there are Obesity Lawyers that will fight your case for you. I post on another board and some of the ladies on there have used these lawyers to fight their cases for them and they have had good results. But, before I would go that route I would find out WHY I was denied...if I could fix it on my own OR is there is an exclusion on your policy. Years ago I was looking into WLS and my hubby had insurance that had an iron clad exclusion..there wasn't a way around it. But...years later I was successful because we have different insurance and I was finally able to have my RNY. Maybe if it's possible you could check to see if your work or hubbies work offers a different policy. Check to see is that has exclusions and then maybe you could switch insurance companies. It's a pain sometimes but if you keep after it, it can work out. I wish you the best of luck!! Heres the other board that I post at www.obesityhelp.com and you'll want to look at the insurace help thread. It's there you just have to snoop around a bit. It's on the "other boards" and then you'll see if if you scroll down. I hope this helps you as I know from personal experience that this is very frustrating but I have also seen denials for the silliest smallest reasons that are very easily fixed......