Insurance denied, now what?

Updated on October 20, 2019 in Insurance & Financing
5 on August 27, 2019

I’ve been obese for as long as I can remember, so I’m not sure why my insurance is refusing to cover weight-loss surgery.  I just got the coverage denial letter today and their reasoning is rather vague.  The letter states that at this time, weight-loss surgery is not a medical necessity for me.  I’m so shocked by this since I meet the guidelines.  My BMI is over 35, I have at least one serious health problem that’s linked to obesity, and I’ve tried many other diet plans before seeking surgery.  I’m so devastated by this news!  What are my options now?  

 
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0 on August 29, 2019

I’m so sorry that your insurance denied you! That has to be so incredibly frustrating.

Can you have your doctor help you appeal their decision? It sounds like you have a good case for an appeal. 

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0 on August 31, 2019

I’m also sorry to hear about that, Samantha. Isn’t your surgery recommended by your doctor? I wonder why the insurance company would think that you don’t need it when it’s you and your doctors who know what’s best for you.

What about independently paying for your surgery?

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0 on September 6, 2019

My husband had a hiccup too.  It turns out that we didn’t provide enough detailed information  that the company was looking for. Sometimes there are specific phrases that they need to see, which is ridiculous in my opinion, but what can you do except try again.  I’d call the insurance company and ask for specifics as to why you were denied.  Then work with your doctor to straighten things out and resubmit the paperwork.  Good luck to you!

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0 on September 10, 2019

Thanks guys for the helpful tips!  I took your advice and got everything straightened out, so the insurance company has finally approved my surgery.  The holdup was over all the methods I had tried in the past to lose weight.  Apparently I needed to provide more details.  I’m incredibly grateful for the help and I can’t wait to start this journey.  

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0 on October 20, 2019

Medical Tourism, is your answer. I did mine Tijuana after 3 denials.(same answer) I can get you scheduled in less than a week from today. I’ve been on the loser bench for 6years …the answer to every shut door, exists a better one by God IMO.

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