Insurance uncertainty -- now resolved!!

I want to share with my Obesity Help family a very good service that I have received.

According to the Plan Details booklet sent to my home by my health insurance, I have coverage for WLS as long as I have BMI above a certain level, plus co-morbidities (ie., disease states such as sleep apnea, hypertension, diabetes, etc associated with obesity). However, when I called the insurance's customer service line (several times), they insisted that I do not have such coverage at all -- they said that I have an "exclusion" for WLS!

I called the Lindstrom law practice www.obesitylaw.com at 877-99-APPEAL for one of their brief no-charge consultation. I spoke to Kelly there -- she has been so helpful! She and I made a plan, and part of our plan was that I would hire them to help me if I got a denial. She helped me to understand what might have been going on, and she helped me to feel less anxious about this distressing situation!

Well, I got the authorization -- no denial -- and my surgery date is March 11! As it turned out, I did not have to hire Lindstrom after all. But, it was so good to know that that was an option!

If you have insurance questions or frustrations, do consider calling them -- I get NO financial benefit from posting this, and I have NO financial relationship with them. They have wonderful expertise and really understand what the process of getting approval involves, and what insurances are supposed to provide. 

When I first contacted my insurance company 3 years ago they said I had to do a supervised diet for 6 months yet the insurance person at my surgeons office said otherwise. She said that they previously had that requirement but had done away with it plus they had done away with the pre-approval. As long as I had the BMI and co-morbidities ( I was a lightweight) they could schedule me for surgery. I scheduled and then called the insurance again and was told all of what she had said was true. Nuts! I did have to file for approval for my revision because of the one wls per lifetime thing. Even then they approved in less than 4 weeks.

Never, ever put up with denials. You can out wait them.

Good luck