State by State Lap Band Surgery appeal rights link

jbuntjer

The policy with AETNA at my husbands job specifically excludes weight loss procedures of any kind...Is there ANYTHING I can do?

BensonRN

Does anyone know if it is easier to get approved from HMO or PPO insurance. I am in IL. I have to choose my plan on Nov. 18 so I am trying to choose the easiest route. Thanks.

marty123

I have United Healthcare and they tell me they do not cover this procedure. Did you get approval? How?

marty123

I have United Healthcare in Kentucky and they will not cover this. Can you give me any idea on what I should do to get approval? Thanks

JDUB0414

I also have Aetna and have been denied because I only have four of the five years needed to get approved. I just filled out the form on obesitylaw.com. Has anyone here used them?

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3/19/2008-Surgery Date

webashley

I did. Bad move. I was approved, and posted my whole story on OH.

I ended up having my appeal fixed by obesitylawyers.com they post here and other sites, freely helping people, i'd try there first.

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-Ash

manykids

Gary just wanted to tell you from any info I ever picked up from you on the internet and web page I was able to successfully fight the insurance decline of lap band surgery and get it approved by independent medical review board. If not for all of your input I could not have figured out how to do it. Just wanted to let you know that your taking the time to help others is getting us the help we need and really save our lives in the long run . Thanks again.

manykids

I highly caution you with choosing your insurance carrier. YOu must call the Member Services of each carrier and ask them what their policy contract states for having lap band surgery. You are lucky you are being given the opportunity to be able to choose. The Member Services Dept. are set up to look up policy contract according to each plan, HMO or PPO and tell you what their guidelines are accordingly. I can tell you right now United HealthCare is giving people alot of problems paying claims of any kinds whether it is lap band or any other type of surgery. Been all over the news in CA on how poor they have been paying claims. So try to go with someone else. Call and do your research, and don't take an insurance agents word for it, go to the insurance carrier.

misshonesty

Hi, I was wondering if anyone has medicare and missouir's state ins, I know it is Coventry, and have been told coventry rarely will pay for wls, even though Medicare is my primary ins, any info or advice would be appreciated, ty, B

MrsBuckeye

I'm in Ohio and even though I have read that some folks who have MedMutual have had various types of bariatric surgery approved, the company I work for has it "excluded", as does my husbands insurance. I have tried twice and have been declined - any ideas ???

My sister has had it twice - I can't get it once :(

Sher/Ohio

boomboom

I have Aetna insurance and they have denied me because my bmi was under 35 in 2006. Has anyone experienced this and if so how did your appeal turn out.

MrsChar

I talked to my Dr and she says she would recommend WLS for me, so I have her support. I called my insurance and they say they don't cover WLS. I have Blue Cross-Premera PPO Can anyone tell me the next step to proving its medically neccessary? I have diabetes due to my weight, along with sleep apnea, constant bladder infections due to the diabetes. Like many of you I have tried all the diets and gyms, and my wieght goes up and down. At my largest was 300 pounds @ 5'5, currently I worked myself back to 270 but its an everyday struggle. I just want to be healthy again

roxie

Hello,
Were you required to provide a 6 month doctor supervised restricted diet to Aetna?

Perky66

What form?? I don't know anything about a form. My PCP would willingly fill out a form for me but I haven't been told of any forms.. Help!!!

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foolsrushin772

i would like to tell all of you that i'm on medicare and i live in south dakato ,but went to detroit mi. for Lap Band surgery. had no problems what so ever. theres no 6 month dieting for approval which i loved. if we could lose weight in 6 months we wouldnt need the surgery. i had a surgery date in 2 weeks thanks to my family dr. getting all my tests done in one week. living on the prairie pays off lol. its been 9 days since my surgery and i'm doing great. i had no pain and no gas and no problems except flying there and back. its was 2 very long days and i was very tired. i had a world renowed surgeon and i never met him until just before surgery. he was wonderful, we did get to talk awhile when he discharged me. his last worlds were call me anytime day or night if you have anymore questions and i would be happy to talk to you. he even gave me his home phone and 3 cell phone numbers and office number too. i would go back to him in a new york minute. i'm still on liquids, full liquids and thats fine. i'm suppose to have my first fill may 1st, but i dont think i'll need it. we'll see. i'm never hungry, but i do everthing i'm suppose to do and i'm losing weight. i've lose near 20 lbs. and exercising everyday. i do the treadmill 30 minutes and bke 30 minutes. i'm kinda disabled so that will probably be the extent of my exercising program. sorry got kinda long. if u have any questions just ask i'm hear to tell all...........foolsrushin772..........sue heres hoping u all do well on your journey.

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