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Insurance denied! Know of an alternative?


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Beginning my journey and hoping some of you old pros can help me! I'm a female, 5'8, appx. 275, BMI of 43.

I went to a bariatric surgery seminar offered by a local bariatric surgery group. After completing piles of paperwork and setting up an intial consultation for surgery, I found out my insurance denied my request for surgery. I have Premera Blue Cross. My policy has an exlusion that allows no claims for any overweight/obesity surgeries, etc. I was told there are no exceptions to the exlusions and I cannot file an appeal. There is nowhere further to go with my insurance (that I know of).

I know of the self-pay option but I simply don't have the money for that. I can't pay it in full nor can I take on another $300ish monthly payment.

Here is where I need your help! Do you guys know of any grants, opportunities, etc. to help with these types of surgeries? I am at rock bottom and was holding on to the wish of surgery as my biggest hope.

Thanks in advance for the suggestions, stories, knowledge!

Stephanie

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Hi Stephanie, Does your company have other options for insurance, can you change plans at open enrollment? I am in the same boat as you, but I can change insure during open enrollment in November...

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Only varied coverage levels from the same insurance provider. But, I hadn't thought of that route! It is most certainly something I will look into at open enrollment. Thanks for the tip! Good luck to you!

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What about purchasing your own policy. They are really not that expensive, I don;t know your age or any other health problems. You will have to pay a little more because you have a high BMI. Shop around you can always cancel the insurance after the surgery.

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I've actually been doing some research on just that! I am currently 24 and due to the new healthcare regulations, I can still be placed on my parent's insurance until the age of 26. So, we are looking into using their insurance to allow me to have the surgery. If that doesn't work, I will certainly dig deeper into purchasing my own policy! Thanks for the advice. Outside of obesity, I'm in good health and a non-smoker. I would think it shouldn't cost me too much.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
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      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

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

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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