Frustrated.

[Wisdom2KnowTheDifference 32]

Hey all,

Just so frustrated with hubby right now and I need to vent. My insurance (United Healthcare) told me that my policy doesn't cover WLS. I looked up general UHC requirements anyway and they say 40+ bmi or 30-40 with comorbidities (I have 36 bmi and no comorbidities that they list, though I do have some relatively minor health issues related to my weight).

My frustration is, he (husband) was initially completely "on board" with this but now says he still wants me to go through process of submitting to insurance. This irritates the hell out of me because we are fortunate enough to have the resources to self-pay regardless... Ugh!!!

I guess I just feel pretty darn sure I will be denied by insurance, and all this is just going to delay getting my surgery date. I understand that it is a lot of money but I feel like this is my health we're talking about here?! And, I hate to take it here, but, I'm the breadwinner in this family..

Perspectives? Thoughts? Am I being a brat?? Please be honest

Thanks!

[DELETE THIS ACCOUNT! 12,703]

Honestly, I agree with your husband. Submit it through your insurance and exhaust all options with them first, then move to self pay if you have to. Why spend tens of thousands of dollars if you don't have to? You pay for insurance so make the most of it and use it if at all possible.

And honestly, so what if it's a small delay? It's not optimal but it's not the end of the world either. Many here have to go through 6 months of doctor supervised diets before their surgery. It's not a big deal to have wait a little bit. If anything, it gives you more time to prepare and thoroughly educate yourself about the band in advance.

Best wishes.

[Wisdom2KnowTheDifference 32]

thanks for the feedback. I do tend to rush things, once I get excited about something sigh!

[TKW 501]

I would let it run through the insurance also. It doesn't take that long, a few weeks probably less if they say no!

Good luck to you.

[Joyce Real 21]

My surgeons office checked before I did any of the pre-op requirements. I was self pay, because my company did not offer it in the plan at all. If you are self pay you do not have to meet the same requirements either!

[Longleggs 11]

Strongly suggest going through insurance! A co-morbity that you could have and not know is sleep apnea. The time that it takes to get approved you can also do a ton of research and prepare yourself. Slow and steady wins the race

[PandorasBox92264 61]

Work through the insurance process and see what the insurance says.

If they do go ahead and pay for the surgery, then you will have that money to take a trip,

get new clothes, put towards a house or a second house or whatever you might want/need.

The process will not be delayed that long, and get yourself in the mindset of preparing for the band.

[2muchfun 8,927]

Check with the insurance expert working in your doctor's office. They've seen this a hundred times and can give you a better perspective on how feasible it will be to be approved.

I know $10K or more is a lot of money. And I agree with the others about exhausting all attempts to have insurance pay for this, but wholly crap, some of us don't think anything about dropping $25K on a new car, or $30K on a boat, or $15K to remodel a bathroom. This is our bodies, our future. If we're not worth it, what is? Not a piece of metal and plastic that's for sure.

tmf

[Bamabander 111]

I had UHC last year and it was excluded by employer. I jumped through a bunch of hoops, but you can not appeal it because it isn't covered. Think about car insurance, if you don't have rental coverage there is nothing you can do to get your rental car paid if you need a repair.

I was fortunate enough to realize we had another policy available that did cover it. Had to wait til jan 1 for that to change over but did pre op in meantime.

I do not think you are a brat... It simply isn't covered, why go through it if you are going to pay yourself anyhow? The only option is to go to your HR and ask them to consider changing the policy or agreeing to cover yours. You must have facts on why you will be a better employee. Like less sick time etc...

Good luck, but I say, after being through it, don't bother submitting! Good Luck!

[Kathie52 31]

I agree with longleggs! I have Cigna and had to wait 6 months, which upset me, but I now realize that it was good for me. I did a lot of thinking. Getting my head right. They just recently changed the policy to 3 months. I know your frustration!