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insurance question...HELP!!

morgandonor

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peacequeen    434

peacequeen
Posted

Morgandonar, I just realized you are from Ky...so am I! Check out Central Baptist in Lexington. You can sign up online for the seminar and you could register as a self pay to get in. I'm insured so I didn't really focus on self pay so not sure what the payments would be but there will be someone there to answer your questions. You aren't commiting to anything by just going to the seminar..and I didn't have my paperwork completed when I got there so I wouldn't stress about anything till you get some answers. With a bmi of 52, you shouldn't have any troubles qualifying. Dr. Weiss is very knowledgeble and they are rated up there as the best in the state. I was so impressed and relieved afterwards.

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Acadia    20

Acadia
Posted

Point blank: if your policy specifically excludes weight loss surgery then you cannot appeal it. You will be self pay if you proceed.

Weight loss surgery is considered elective surgery and falls to the employer to determine whether or not they will cover it. It has nothing to do with the insurance plan itself, only the waivers and restrictions/exclusions that the employer chooses.

I work in the insurance industry and have worked at two separate insurance companies one with exclusions and one without.

Check to see if your company offers more than one plan option, they may not have excluded it in both. Or look into personal insurance.

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mattie7632    24

mattie7632
Posted

Right--people get very confused with the authorization of the procedure vs. actually covered on the policy!

Point blank: if your policy specifically excludes weight loss surgery then you cannot appeal it. You will be self pay if you proceed.

Weight loss surgery is considered elective surgery and falls to the employer to determine whether or not they will cover it. It has nothing to do with the insurance plan itself, only the waivers and restrictions/exclusions that the employer chooses.

I work in the insurance industry and have worked at two separate insurance companies one with exclusions and one without.

Check to see if your company offers more than one plan option, they may not have excluded it in both. Or look into personal insurance.

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morgandonor    0

morgandonor
Posted

i just wanted to say THANK YOU x5 to everyone who has responded. i have decided to have my dad add me to his since he just switched jobs, and in the mean time work on my eating habits and walking. if something goes wrong with him adding me, or his employer has an exception, i will finance the surgery and keep my hoopty car for a couple years. :-/

PEACEQUEEN-YES!!!!!!!! my seminar is for Dr. Weiss and Dr. Oldham!!! that just made me feel so happy :)

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peacequeen    434

peacequeen
Posted

Yay!!! I'm so excited for you! I think you'll find the seminar very educational and informative. Hopefully they will be able to answer any questions you may have afterwards! Good luck and keep me posted!

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Go To Topic Listing PRE-Operation Weight Loss Surgery Q&A

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    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.

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