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Insurance problems/rant! Anyone else?
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Hello,

I’m really frustrated with my situation with my insurance. I was scheduled for gastric bypass on 12/09, was a week into the diet and the insurance denied me. Okay, whatever… I was considering not getting the surgery at all at that point. My doctor submitted a stage 2 appeal AND did a peer to peer. After then being denied for both Wegovy AND Mounjaro I decided I wanted to go through with surgery for sure. Went through the absolute mental hell of trying to decide if I wanted sleeve or bypass because I wasn’t comfortable with the idea of bypass. Decided to do sleeve, let my surgeon know, and got the sleeve submitted to insurance only to receive the DENIAL for the stage 2 appeal for bypass. Paperwork’s vague I call and ask why they denied it. They say at first it’s bc there’s no documentation of weight loss, exercise or diet change. I’ve seen the nutritionist 5 times. I’ve implemented change. They then say oh you need to see a nutritionist or medical doctor 12 total times. Which I’ve DONE if you count the wellness checks with my surgeon. I’m now on the pre-op diet for the SECOND time trying to get this approved by 1/20. I HATE AETNA!! Anyone else commiserating with me? I’m so upset and annoyed and discouraged. This diet is so rough. Can you tell I’m emotional? Fml.

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1 month ago