Question:
Tried years ago denied; Ins now doesnt say anything about "med necessary"

I tried years ago and was denied. Gave up wishing. New Ins. doesnt say anything about not even if its "Medically Necessary". Its been so long should I send a letter from my Dr. stating so? Please help.    — rinkadinktx (posted on May 24, 2009)

May 24, 2009
Irma, I would call my insurance company and ask if they pay for WLS and see what they say. If they say yes with guidelines, find out what they are and see if you meet them. I would try, it can't hurt. Good luck. Vickie
   — lpn_1992

May 24, 2009
Don't take no for an answer. Get busy and flood them with medical opinions from your doctors as to why you need the surgery. Get several copies of your letters and keep them handy so you can send them about every ten days until they give you an answer.
   — texasred

May 25, 2009
I just got approved from the insuance company on Friday and I am so thrilled I cried. If it wasn`t for my WLS surgeon fighting for me they would still be denieing me. It has been a long, long journey to this point and I never lost track of my dream of having WLS. Please don`t give up!!!! It will all be worth the battle in the long run. Good luck and best wishes!! Patti :)
   — Patford

May 26, 2009
I have discovered that every insurance is different and have different requirements. Some require you to be on a supervised diet for six months, see a psychologist, etc. Mine only required a five year weight history from my doctor and proof of other medical problems, i.e. high blood pressure. I have a friend whose insurance normally won't cover wls but she was advised to submit a letter from her doctor and they would consider it. (She hasn't gotten a response yet) So, it definitely wouldn't hurt to give your insurance a call and ask. Good luck to you!
   — Char-Ree C.

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