Re: Fw: BCBS OF NC RUN AROUNDS

[Guest guest]

Joyce,

I am so, so sorry this happened to you. Good luck on your fight -- do call

the insurance commissioner.

Sincerely,

Jennah

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" When I get a little money, I buy books. If there is any left over, I buy

food and clothes. "

(Erasmus)

[Guest guest]

Dear Joyce, My suggestion? Talk to the supervisor. If no result, talk to

the level higher. Next, tell them that you know other bariatric procedures

havre been covered for other people; that you feel discriminated against and

that you may need legal advice. Ask for an in-person meeting with a decision

maker. Bug the sh-- out of them. No rest. No peace. They'll approve you

if only to shut you up. Also, go to obesityhelp.com; klick on enter; k on

morbid obesity support; k on research insurers. There you can scroll down to

your insurance company, see others they've approved and/or not; and even

email those folks. Gather your data. If you are not too rude, and not too

abrasive, and full of facts, such as defining medical necessity, you will

prevail. They don't require a brain tumor to weigh a certain amount before

they remove it; or a thyroid goiter or whatever. Only fat people are thus

abused. Fight them. We are creating a pathway for the next generation of

people with this disease to make it easier for them. You go girl. PhillyJude

[Guest guest]

Also, you're in NC. Hundreds of NC folks have been approved. Many of them

had BC. Keep gathering your data. We're all supporting you. PJ

[Guest guest]

Hey Joyce,

First of all one of my similiar problems is I am also, 5'2 " and I weigh in at

335.. sound familiar so far?

I am 53 yrs. old though, and have been wondering everything you just asked for

about 30 yrs. now.

It don't get no better. People worry so much about racism... what do you call

the bigotry we suffer from?

(pst. I'm venting too!)

You fight that darn insurance company... You have a really good chance to win,

beings you've been excepted by other programs.

Best Wishes to you, and by the way you have reached a web site full of people

who understand EXACTLY what you are going through.

I am a self-pay, I don't have years to fight insurance ignorance, but maybe

there are some people on here with the same insurance as you, ask!

Trudy Indiana

pre-0p (but soon...)

335, BMI 61

BCBS OF NC RUN AROUNDS

Hello,

I am new to this group. I have been reading it for awhile. The things I had

to take from this thing that calls himself a PERSON at Blue Cross and Blue

Shield today stinks!

He told me that first of all they NEVER rec'd any of my 5 faxes that I resent

from Dr. R. When I told him they had accidentally faxed me back and I had their

fax.. then he didn't know what to say.

Then he said, they have tons of stacks of paperwork for pre-approval and it

would literally take months to even get to mine to even say they had rec'd it.

He told me that a gastric bypass is not covered anyway and it would ONLY be

out of COURTESY they would even review it for me.

I told him that I read in my policy and ON THEIR website that IT IS covered!

I asked him if in fact then that it is true, that a PERSON COULD DIE WAITING ON

AN APPROVAL from the insurance company.

He stated, " HE HAD NEVER SEEN ANYBODY DIE FROM NEEDING A GASTRIC BYPASS " !

He just kept giving me the run around after run around. I asked him how many

times it was going to take for me to fax it before they said they received it?

I told him I guessed that I was just going to have to call the INSURANCE

COMMISSIONER about it....

then... little told me, well why don't YOU have your Primary Care call

us and then we might find your faxes!

So I asked him, if indeed what he meant was that it was there, but they were

just going to ignore me forever... unless that was done. He said, something

like that.

My local BCBSNC office is out of Durham even.

ANYBODY ELSE HAVING PROBLEMS WITH THESE PEOPLE, I MEAN INSURANCE COMPANY?

I was approved by Aetna in 1997 for the Fobi Pouch procedure in California.

That was at min. $42,000. Things happened and I was not able to fly to CA to

have it done. Then I was approved again.. in 1998 at ECU and then they would

not do my surgery. It was the lap band, and they said I had acid reflux and was

NOT a good candidate. They also thought I lived too far away...if I had any

problems...

so now, I find a Dr. in my back door...and I end up with an ins. company who

hates Fat People and thinks we are lazy and non deserving of medical treatment.

I understand the risks of surgery..and have been there and done that ..with

pre op after preop.

My uncle who was over 400 lbs tripped and fell and it made his heart stop

beating... He died at age 42. They had to special order a casket even. My dad

died of a 2nd heart attack at age 64 and had his first heart attack younger than

what I am right now. 41

I have gained 160lbs since 1992..and at this rate... 330 lbs and 5'2 I will

be dead before you know it.

At my work they give me a hard time because it takes me longer to walk to the

bathroom and back than my skinny coworkers... I can't walk, and have very bad

feet because of it, and they just say LOSE WEIGHT, and you won't need to park in

the handicapped spaces.

I work in reservations and get out of breath talking and explaining things to

people...and I have to take a minute to get a drink of water and catch my breath

between calls.

Now I got in trouble because I took an average of 21 seconds between my calls

in stead of 20 seconds for the quarter.....

Gimme a BREAK.... DID ANY OF ASK FOR THIS DISEASE WE HAVE?

DO PEOPLE ASK FOR BRAIN CANCER OR BREAST CANCER?

DO PEOPLE ASK TO BE HIT BY CARS?

WHY ARE WE SUCH A DISGRACE TO PEOPLE, WHY ARE WE IGNORED, WHY ARE WE NOT

WORTHY OF BEING HELPED IN A STORE...

THANKS FOR LETTING ME VENT.... anyone have any similiar problems?

Joyce

Raleigh