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Insurance Discuss insurance topics for the gastric bypass and Lap BandŽ operations.

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Old 02-20-2009, 01:52 PM   #11 (permalink)
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Yay!! Congrats!!! Persistence pays off once again!
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Old 02-20-2009, 01:59 PM   #12 (permalink)
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Congrats!!!
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Old 02-20-2009, 02:04 PM   #13 (permalink)
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Quote:
Originally Posted by adagirl View Post
Congratulations!!! Do you mind me asking what their reason was for denial so many times? I have Aetna and expect to be denied because I didn't have a BMI over 35 for the past two years (because I was dieting those two years), but have 35+ BMI history going back as far as 8 years. I've got the co-morbids covered, though, and everything else. Anyway, I'm expecting to be denied and may have to go as far as external review as well if they won't consider my weights past two years.

The reason for first denial was.....my doctor and his notes (they were horrible....bad enough that I had to find another Dr. and do another 3-4 months of the diet). The second time.......personally, they didn't ever read all of the data that I sent in. The third time......my Attorney faxed them everything, including bloodwork, etc. (19 page letter w/documents)....they didn't read that either. Then I had the option for an "external review" and that did the trick......Thank God! I'm sick of being overweight and mostly being told NO by my insurance company.

You shouldn't have any problems getting approved. If you have 2 or more co-morbids along with a BMI of 35 or higher.....you shouldn't have any issue.

Last edited by Native2u; 02-20-2009 at 03:43 PM..
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Old 02-20-2009, 02:31 PM   #14 (permalink)
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Surgery date :Friday 26th Sept 2008

first fill 24.11.08 =6.5cc

Second fill 29.01.09=1 ml

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I love my band ! 5 stone gone thats 70 pounds

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Old 02-20-2009, 03:07 PM   #15 (permalink)
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congratulations!!!!
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Old 02-20-2009, 03:47 PM   #16 (permalink)
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Congratulations!!!!
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Old 02-20-2009, 04:26 PM   #17 (permalink)
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Woot, woot! That's GREAT news!
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Old 02-20-2009, 05:19 PM   #18 (permalink)
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Awesome! I've been waiting for you to post good news about this.
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Old 02-20-2009, 05:42 PM   #19 (permalink)
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Hooooooraaaaay! Congratulations!
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Old 02-20-2009, 06:15 PM   #20 (permalink)
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Thanks again everyone!

These messages really mean a lot to me! I never thought this day would come. I'm a happy camper now.
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