What if Isurance does not approve

justpeachytexas · 05-16-2008, 05:12 PM

My DH brought up the question. "What if your insurance does not approve the band?" We had to file bankruptcy so that leaves out financing. I don't know what I am going to do if they do not approve. After Monday I have 4 more months to go before I find out

edieparks · 05-16-2008, 05:26 PM

Are you positive you won't be able to get financing?
edie

Enchanted · 05-16-2008, 08:23 PM

My suggestion is that you call your insurance carrier and get a listing of all of their requirements for qualification and then document, document, document.

I documented all of my attempts at weight loss -- low carb, weight watchers, blah blah blah -- how much I weighed when I started a particular plan, how much I lost on that plan -- and then was able to show that I also regained. I also documented my struggles with diabetes -- when I was under good control and when things were more difficult to control -- which meds I was taking, etc.

Be well-organized, know your policy, meet their requirements and then be hopeful.

If you are not approved, you have the right to appeal the decision by supplying additional information.

Best of luck to you.

Jessica1977 · 05-16-2008, 08:44 PM

If you do what Enchanted suggested I think you will have a very good chance of approval. I was denied when all my paperwork was submitted, but appealed and got the additional info they requested and then was approved a few days later. I also went into the lap band journey not knowing if I would be approved either, so just try to stay positive! Good luck!

justpeachytexas · 05-19-2008, 09:50 AM

Thank you, I just get to over thinking.

Livingthe Dream · 05-20-2008, 10:38 AM

My insurance would not cover me because I was 85 pounds overweight and not 100 pounds. I told my doctor to give me 30 days and I will hit that number no problem. Once I started looking at the numbers I realized that I could earn the needed 10k for the surgery faster than my insurance company was going to help me. I say go the insurance route but in the back of your mind keep the idea of paying cash for your dream. Dr. K in Colorado charged me 10 k for everything and he is one of the best out there. Insurance is not the end all be all they are just one option. You said you had 4 months till you know for sure so delivering pizza's at night (or something) could be your solution. I am now sporting a 36 inch waist and at 35 years old matching my US Navy measurements when I was 26. I saved up the 10k then charged my Disney Visa card for it, paid it off and now going on a cruise after losing 80 pounds. You can do it don't let red tape stop you.

luvinke · 05-28-2008, 11:13 AM

I hope that your insurance approves you the first time, if not the Doctor's that I researched here on line help you go through the appeals process, which I think you should consider if they deny you the first time. If not keep checking on this site, as there are many adds to the right of the page where you can get certain Doctor's or banks to finance it. I have to tell you that if my insurance didn't pay I would have used my tax money, plus my savings, a loan, credit card whatever it took to have my surgery. I love my band and I like looking in the mirror because I'm pleased at what is looking back at me. I have lost 38 pounds in almost a year, but I've lost so much more in inches that people have a tendency to think that I lost about 50 or a little more. I feel great! Pray on it and do whatever it takes to get your surgery. That part time job for 4 months until the insurance gives you their answer like Livingthe Dream said doesn't sound like such a bad idea. Best of luck to you and I'm sure everything will work out. Oh yeah the document document document response sounds great too.