ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum - View Single Post

katzz87 · 06-07-2009, 10:28 PM

Quote:

Originally Posted by Native2u

Cathy,

Please don't take this like I'm attacking you...I'm not.

Did you have to fight for your insurance company for over a YEAR for them to pay for your WLS....even though, you qualified? I sure did! I had to hire an Attorney to fight this for me (more $ out of my pocket). I'm telling you, it wasn't fun!! I had to jump though SO many hoops, even though I qualified in the beginning.....and I kept getting letters of denial.

Don't think for a second that an insurance company will even drop their BMI requirement, just because a person has several co-morbidities....it just doesn't happen. Insurance Companies don't work like that.

Insurance Companies want our money ever single month, but when we need them for a life saving surgery (WLS), something that will pro-long our lives and make us healthy again...they have NO interest in helping, even IF you meet THEIR criteria for surgery.

I'll get flamed for this...but I had been working with doctors, nutritionist, exercise regimen for YEARS trying to lose (and keep off weight)...so luckily I had everything documented and from the first time I saw the WLS doctor till surgery was 3-4 months it was that long only because I changed from lap-band to gastric bypass. Does that make my journey any less difficult? I had diabetes, high cholestorel, high blood pressure, among other issues that I fought for years and years.

My insurance told me flat out that it was up to my doctors facility if my surgery was approved. As long as my doctor approved, the insurance company had no "approval" in the process. I realize that all insurances are different...but that was how it worked for me.

I felt the Jersey's comment was actually pretty supportive if you would get past the first sentence.

And no....I didn't take this personally.