Guest guest Posted October 11, 2000 Report Share Posted October 11, 2000 , Don't let one person's answer stop you. When there's a mountain in your path, drive around, or over, or dig a tunnel. In other words, look for Plan B and even Plan C. Ask to see the policy. Have someone with law background, maybe legal aide, read it. You have a medical necessity. Some insurers refuse and expect that you will slink off quietly. Don't. Fight. You'd be surprised how many people who were told no once, got a yes on the 2nd or 3rd try. Plus, what about oopen enrollment ? Switch carriers? Go to: obesityhelp.com and research your insurer. If they approved someone else before, then why not you? Don't give up yet. You're far from finished. We haven't even mentioned being a self-pay. What are those chances? Girl, there's lots of hope still around for you. Ask others with your insurance what happened with them. Out it on this site, ask anyone with ---- insurance what happened with them. Please fight. They're not thru with you yet!! PhillyJude Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2000 Report Share Posted October 11, 2000 Is this an exclusions policy? What does your coverage book say? What state are you in? Here in Ohio, we have House Bill 4 that passed and HMO's that want to go against national standards must go through the external review organization (ERO) and pay for it. If the state approved ERO says the patient fits in under the national guidelines, the HMO has to pay. House Bill 4 went into effect on May 1, 2000 and I am SummaCare's FIRST House Bill 4 patient. They are a JOKE... Anyway, I believe in prayer. So pray first, for sanity and patience. God is still Soveriegn, don't ever forget that. Next, read that policy... read it and read it again. If there is an exclusions saying NO GASTRIC BYPASS no way no how, then going forward would be useless. Read the policy and let us all know what the wording says. Look under " Exclusions, General and otherwise " . > I knew it, I got confirmation yesterday that I was flat out denied. No > questions asked. There is no chance of me being approved. Now I am in tears. > What do I do. Stay fat for the rest of my life I guess or starve myself and > never eat food again:-( UGH I wish you all knew for real how much this means > to me. I have researched this for over a year now and I just can't believe > my options are none. Please pray. > > In Christ > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2000 Report Share Posted October 11, 2000 , Is there anyway you can self-pay. We got an equity loan, and some help from friends... I can only guess. but I know how that would make me feel! Good luck to you girl, Trudy TOTALLY DENIED I knew it, I got confirmation yesterday that I was flat out denied. No questions asked. There is no chance of me being approved. Now I am in tears. What do I do. Stay fat for the rest of my life I guess or starve myself and never eat food again:-( UGH I wish you all knew for real how much this means to me. I have researched this for over a year now and I just can't believe my options are none. Please pray. In Christ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2000 Report Share Posted October 11, 2000 PhillyJude, I hear you on all that. No one under my insurance has EVER had this one:( They told me no matter what they will not cover such a surgery PERIOD:( Yes I would self pay in a minute. I sure do have the income to pay for a loan BUT no one and I mean no one will give me one because my husband is self employed, I tried that avenue as well VERY SAD, Re: TOTALLY DENIED , Don't let one person's answer stop you. When there's a mountain in your path, drive around, or over, or dig a tunnel. In other words, look for Plan B and even Plan C. Ask to see the policy. Have someone with law background, maybe legal aide, read it. You have a medical necessity. Some insurers refuse and expect that you will slink off quietly. Don't. Fight. You'd be surprised how many people who were told no once, got a yes on the 2nd or 3rd try. Plus, what about oopen enrollment ? Switch carriers? Go to: obesityhelp.com and research your insurer. If they approved someone else before, then why not you? Don't give up yet. You're far from finished. We haven't even mentioned being a self-pay. What are those chances? Girl, there's lots of hope still around for you. Ask others with your insurance what happened with them. Out it on this site, ask anyone with ---- insurance what happened with them. Please fight. They're not thru with you yet!! PhillyJude Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2000 Report Share Posted October 12, 2000 Sorry, . What else can we think of? I hate taking no as an answer. I'm going to keep thinking. Besides, why don't you apply for a loan as separated? They don't need to know. . .would that work? Or a home equity loan? Possible? Or, seriously, a rich friend? There must be a way. I am not ready to give up. How old are you? Do we have time to do weekly bake sales? :-) Would your church help? OK OK How about the lottery? There has to be a way. Keep thinking. Other insurance? Pay a year of premiums with a carrier that does allow it? That could happen. Think, girl. We can get this done!!!!! PhillyJude, with love for my MGB family Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2000 Report Share Posted October 12, 2000 In a message dated 10/12/2000 6:30:17 PM Eastern Daylight Time, Judyh1022@... writes: << There has to be a way. Keep thinking. Other insurance? Pay a year of premiums with a carrier that does allow it? That could happen. Think, girl. We can get this done!!!!! >> You are right! I have heard of women who have done this to have their tubal reversals paid for! They didn't even have to have the new insurance for a full year either! cindy Quote Link to comment Share on other sites More sharing options...
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