Discouraged….Health Insurance – struggle for Gastric Bypass Surgery approval!

Hey guys, sorry that I look a mess – just got out of the shower, and had to unload a little about my disappointing news from the health insurance today…
Video Rating: 5 / 5

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25 Responses

  1. THEPinkRuby says:

    I totally understand….you put so much into the process of getting this
    surgery, to get denied by insurance is like a smack in the face. The
    disappointment is normal but I know you’ll get through it.

  2. IamKris411 says:

    thank you for your support!

  3. IamKris411 says:

    thank you Kristen, I appreciate the support… but I am going to try and
    fight it – because there have been cases already here in Germany where
    someone was denied and then approved – so I am at least going to try that.
    Yeah, I am super disappointed, but hopefully with an appeal they will give
    me a chance. I really feel like I need this to change my life… it’s a
    battle every day – especially with this friggin’ pcos! Thanks again for
    your support!!!!

  4. IamKris411 says:

    I’m not taking it personally yet, I’m just hurt and mad and everything
    because of how much I have put into it already, and I don’t know why they
    haven’t approved/denied me – because I didn’t get the letter yet – I am
    waiting to hear back from the lady tomorrow. I will be happy to tell them
    all the personal and embarrassing things that I deal with on a daily basis,
    if it will help me get approved. I want to shed all of this weight… I
    feel like my life is on hold… but I’m going to fight!

  5. IamKris411 says:

    Thank you for your support, I don’t plan on giving up!!!! I just feel like
    I have already put so much into this, and it’s another huge hurdle, you
    know? I’m hoping that things will look up… trying to be positive… I
    guess I’ll try to do something fun today to get my mind off it a little πŸ™‚

  6. IamKris411 says:

    yep! I’m already thinking in my head of what I am going to write in my
    appeal letter… I am just dreading if they are going to make me go to more
    doctors and have more tests and a big waiting period… but I am going to
    try and think positively.

  7. Diva Taunia says:

    Oh man, this stinks! This has happened to people before, and you just have
    to be super pro-active throughout the appeal process. Write as many letters
    as you can, do as much PCOS research as you can, maybe even try to get some
    press (Michael Moore -style) to talk about being denied and trying to get
    approved….(I can help you with the press stuff if you want). Usually, if
    you cause a polite fuss, you can get what you want. I’ll help any way I
    can. Big hugs, girl…..

  8. Janine Hallewell says:

    Sorry to hear that you are having trouble with your insurance.was not
    successfull. My thoughts and prayers with your Kirsten. My own surgery was
    private, so I don’t know much about the insurance process.

  9. IamKris411 says:

    Hi Taunia, yeah, I’m definitely going to be proactive about it… but the
    day after I made this video, the health insurance called me back and said
    that they would try to turn it around for me – their reasoning for saying
    no, was that I wasn’t on a diet already for 6 consecutive months under a
    doctor’s supervision… but I was in a sport program for 2 years already –
    so they said they’re going to try to use that to get a yes. but I think
    it’s because I said to the lady (cont. in nxt comment)

  10. IamKris411 says:

    thank you for your support. I am feeling so down right now… I am trying
    to be as positive as possible, but I just heard the news today – so I guess
    it’s normal to be a little disappointed for a day…. I am going to fight
    it though. Thanks for your thoughts and prayers, I can use them all! I am
    hoping for a quick turnaround… or even one at all.

  11. IamKris411 says:

    ”No isn’t acceptable, and I am going to appeal this… what steps do I
    need to take next? Do I need to get an attorney?” and she was like ”Oh,
    no – you will probably have to write a letter if anything… or make the
    diet with the doctor, it’s not a definite no.” but I was like thinking to
    myself, why didn’t they tell me there was some kind of diet requirement
    when I called in April 2009? I could have had it done already. Whatever,
    I’m going to fight it!

  12. IamKris411 says:

    Yeah, definitely do all you can to get around it. I think it’s a good idea
    that you are going through H.R.. It really says in your policy, that WLS
    isn’t an option through your insurance? That’s crazy… especially now,
    since it’s not like it’s something new! I mean I live in Germany, so things
    were a little different, but I still had to fight for it – and went through
    a lot to get it, while other people were just approved without so much
    effort. That was def. frustrating!

  13. IamKris411 says:

    @MrzEmpress88 – I did everything that was required of me, and I was very
    persistent. I got letters from my GP personal doc, and from my gym – in
    addition to the other things I had to send in… and I also wrote a
    personal letter. I said to them that no was not acceptable and that I would
    get an attorney if I had to. But ultimately, I had everything that they
    were looking for – all the info, and I asked them if there was anything I
    could do to further it. I’m sorry that I didn’t reply before now.

  14. Brandy Swann says:

    Ohhhh, honey I am soooo sorry!! I know with my insurance the big deal was
    how does this problem impact you on a daily basis. I had to go into some
    graphic detail on how it physically and emotionally affects my life
    everyday. Find out what they want and cater to it. Don’t give up. This is
    not just about the surgery, this is about you. I know the rejection can
    feel personal. Like they are saying you are not worth it. That is not true!
    Don not take it personally. Fight it!

  15. Martin Hentges says:

    I just watched your video. I called my insurance company and they said that
    WLS is not in my policy… I guess I didn’t know that I had to check out
    that kind of stuff. I wrote my Human Resource Dept to see if there are
    other options. Im at a loss right now myself. I meet all the Criteria for
    GB surgery.. High blood pressure, sleep apnea, and a BMI of 52.

  16. SarahWillBeSkinny says:

    Keep fighting! Some people get denied the first time, but the 2nd they are
    approved… GOod luck to you, and sending super duper good vibes your way!
    Keep us posted girl! *hugs* β™₯

  17. IamKris411 says:

    Hi there, thank you for your support. I’m going to fight it for sure… πŸ™‚

  18. Allee Campbell says:

    Could you tell me what you did to get an aproval, I just found out two days
    ago mine was denied also. I am very discouraged but I refuse to give up I
    have gone to far. I also have PCOS and I really just want to change so I
    can become healthy and live a regular life.

  19. IamKris411 says:

    I really hope that I will be approved the second time around! I feel like I
    need this…. it’s really discouraging – but I’m going to try and stay
    positive. I wish I had the money to self-pay so I could just do it and get
    it over with – it’s already been a long fight… but I’m not giving up!!!

  20. AntoniaTakeTwo says:

    Aw I am so sorry I do not know for the life of me why this life saving
    surgery could ever be denied! I hate that they treat it like some sort of
    plastic surgery or something. Even people who are approved have to go over
    all sorts of hoops and hurdles and wait long periods of time. In short IT
    SUCKS and I feel for you! JUST DO NOT GIVE UP OK!!!!!!! You are not alone!

  21. IamKris411 says:

    The most important thing is, don’t give up! If it’s really something you
    need/want – to improve your life, you shouldn’t let anything/anyone stand
    in your way. There are also some good options if you ever need to self-pay.
    I have a few friends on here, who had to do that, and wouldn’t take that
    decision back for anything…. But first see what you can do with
    insurance. πŸ™‚ I wish you all the best.

  22. IamKris411 says:

    p.s. thank you for your support! I will definitely do whatever I need to
    do, to make it happen. πŸ™‚

  23. faithkp says:

    So sorry Sweetie πŸ™ I can see how disappointed you are. Have you ever
    considered trying for a loan and paying for it yourself? I know it is a lot
    to think about having to pay back, but this is your LIFE we are talking
    about. Sometimes it is just not worth it to dick around with these people
    and wait years while they decide your fate. I would go back to Mexico and
    have surgery again in a HEART BEAT. If you want to chat, just let me know!

  24. freshorangina says:

    Oh Kristen, I just saw this now, I am so sorry you are going through this.
    I wish I had some wisdom I could share with you on this subject. All I can
    offer is that you should not give up, if this is what you want and need,
    there will be a way. Please let me know if there is anything I can do. Big
    hugs to you! Things will get better.

  25. IamKris411 says:

    @MermaidMommy08 — well I was denied, and then wrote a letter of appeal,
    and got a personal reference from my doctor, and everything worked out
    great! πŸ™‚ so hopefully it will work out for you as well. Just don’t give

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