Crushed...

[heavenly84 0]

appeal it anyways with a letter of medical ness. it'a a insurance co. job to prevent and discourage you. They not going to say Oh yes well pay for that 35k lab band... NO go to your gyn, primary doctor, and endocrinlolgist, dieticain, you pay for those appointments request a letter... send them in do the 30 day wait... then it should be yeah or nay... if ney then then there's is lawyers with your surgeon's office that will fight with your insurnace co...

[CheckYes 46]

I'm so sorry to hear that. Whatever you do, do not cancel you current insurance without getting another insurance policy in place. I was denied health insurance due to my weight when I tried to get an individual plan. At the time, I weighed 210 pounds. The insurance carrier suggested I get on my state's high risk waiting list for health insurance and I was told that it could take a year before I get insurance.

Having been an insurance adjuster, I can tell you that if there is no coverage on a policy - they will not find coverage.

Maybe consider some of the suggestion about Credit Care and/or Mexico?

Best of luck,

[LisaA 1]

I am a contractor and my family's plan is through our small group of 2. So I am in control of the plan. But I can't seem to find a plan that such a small group can get to cover bariatrics. And i can't go with individual (as opposed to group) because of my weight.

So I opted for Mexico. Ortiz. My date is in September. 6000 plus a 300$ plane ticket round trip from the midwest. They pick you up at the airport and the 6gs includes the hotel room- even if you bring someone-

They have been awesome and accommodating with me.

The kicker is the Dr. here in the states I was wanting to go for when my insurance was denied I decided I was going to do it anyway and no way was I going to Mexico. So I refinanced my house to get the 18,000. Then it was like I couldn't get them to call me back- for 2 weeks, I called every day. I started feeling possessive of the money and not wanting to pay such an ungracious american Dr- here in Parkersburg. By then I had read so much positive stuff about Mexico, and they were so nice- now I'm going Sept 27- can't believe it.

Also there is a place in Detroit that has like 11,700 or something like that- plus the phsych eval. pretty cheap too - but Mexico was cheaper.

Anyway I 'm sorry that you too are going through this - good luck with your decision.

[OnTheWay to Thin 0]

All individual policies that I have ever seen exclude obesity surgery, they just flat dont offer the coverage, so be very careful with this. I worked in insurance a good deal of my life, and just like going to the grocery store and choosing the items you need to make a particular dish, an employer has the option of choosing the coverages they want to provide and want to exclude. Good luck to you.

[MrsRea122008 0]

There is always financing. I took out a bank loan... Well my Mother did. But for the loan its only 200 a month for 5 years.. Which isn't horrible! Good Luck

[LisaA 1]

hi raven, have you figured anything out? if you have any questions about Mexico let me know.

[HNNYPOT 0]

Look into Aetna - everyone I know with Aetna has managed to get bypass or lap band including myself. I still haven't had a bill for the surgery!!

[Lady Lap Band 71]

wlsfa.org check that website out. They help people who are denied by insurance. They are a great organization. Good Luck!

[chris1021 0]

i have aetna and have researched their qualifications on the surgery. they cover but you have to fall into certain categories. go to aenta's website and search lap band in their search engine and it will tell you about their coverage :biggrin: good luck

[Banded-Sept-2010 0]

Have you considered signing up for a clinical trial?

Here is the government website for clinical trials on lapbands.

Search of: LAP-BAND®® - List Results - ClinicalTrials.gov

[SunneeHunnee 0]

That sucks. I work for a local health dept and our insurance co-op does not have it for an insurance option even if the employer wants to purchase it for additional dollars. The governing board for the health insurance co-op votes on it very year and they want to keep costs down for the members so they vote to never add it as a rider or benefit. "stamping out obesity" is the Soup de jour of my employer and yet, I got no help with my surgery. I spent 17K for the surgery. My insurance did cover the pre-op screens because they put my diagnosis of diabetes. Other than that, I took my life saving and did it. I have not lost weight fast as many other have, but I am taking less meds and feel SO much better. There is no one in the world better to invest in than yourself. GOOD LUCK.

[shelley1057 0]

My former insurance co. wouldn't cover the procedure . And this is a Medicare HMO which has to cover all the same stuff Medicare would cover. So I switched insurance co. in January. I asked the surgeon's office which companies they had the best luck with and got Humana HMO. They covered everything except for the $100 co-pay I was responsible for. They actually have their own bariatric dept. which contacted me after the surgery to check up on me. They will also cover the fills without me having to pay a co-pay everytime I go to the office. It might be worth checking into switching to a different company. Might pay a little more but still should be able to get under a group rate.

[spoiltmom 44]

All individual policies that I have ever seen exclude obesity surgery, they just flat dont offer the coverage, so be very careful with this. I worked in insurance a good deal of my life, and just like going to the grocery store and choosing the items you need to make a particular dish, an employer has the option of choosing the coverages they want to provide and want to exclude. Good luck to you.

ITA. I used to work in insurance also and this is absolutely correct. Most individual plans don't cover bariatric and with group plans the employer can pick and choose what they will cover and what they require such as BMI and co morbidities.

[Sindy SUe 2]

If your employer chose not to include that covered benefit you would need to appeal to your HR department as they are the one making this choice. (I am not sure if that is your case) I know this because my husband"s employer dropped the benefit in Jan 2010. I had already started the 6 month supervised diet & attended a seminar in Nov. 2010. There was nothing in the info they gave us saying they were going to drop the benefit. I spoke to the HR person and filed an appeal with them (including my PCP supervises diet visits, the seminar I attended, a personal letter from my PCP stating medical necessity, co-morbidites, ect, and brief resource notes off the inernet regarding WLS). It was a long shot but I actually won!! After I picked myself up off the floor, I scheduled surgery and had it 8/26/10!! So I would at least try. SOrry for the long post but if it helps someone else it would be worth it. I have eight kids and could not have done self pay.

[Sindy SUe 2]

Sorry I noticed that I said Nov. 2010 & meant Nov. 2009!! Sorry!