After 6 months of preparation, over 60 lbs lost, a sleep study that I'm pretty sure gave me pneumonia, an upper endoscopy, and thousands incurred in medical expenses, it turns out that the clinic made an oversight and bariatric surgery is excluded from my insurance. So the thing that I had been planning my whole life around for the last 6 months will not be happening. Also gone is any hope I had attached to it. I usually carry myself as a confident person, and don't like to show any signs of vulnerability, but my life has just been shaken to its very core. And all the clinic could offer was a sincere apology.

They say to never attribute malice to what can be explained by incompetence. But how can I not? Maybe I'm burdened with having unreasonably high expectations of people. When they way is shown to you, and you are motivated by that hope, only to see it ripped away from you just at the moment it seems so real that you can touch it. How can one not be angry? Because a seemingly minor clerical error to them has far reaching impact on the lives of the patients and their families. How can I not take it personally? They've told me coldly that they can no longer help me.

I'm sure people have gone through this, and I have been told that I wasn't covered before. But that was before I went through the whole agonizing pre operation ordeal. One that is both physically and psychologically taxing. I've talked to everyone I can, and it appears that there is no recourse for me. And I have no fight left in me. Where do I go at this point?

I don't want to be the naysayer here, but when it comes to our health and our health care we need to be our own advocates. You can't listen to what Dr.'s offices or staff have to say. You need to call your insurance company and find out directly what is covered, what is not covered, ask them a million and one or more questions you are paying them for goodness sake and it is their job to provide you with the answers to ALL your questions about your health care coverage and plan.

it stinks to have gone through all those tests to find out that your coverage excludes this type of surgery but don't give up, and don't look at it as an all for nothing. You found out some very important things about your health that will help you in the long run to be healthier. In the mean time call your insurance company and ask them why the preclude this type of surgery, and if there is an option to have it included. Is it because of the employer not opting into a part of the plan? Are there any other options for Weight Management that they suggest under the plan? If it is an employer exclusion is it possible to speak with your HR staff about it and see if an exception might be made?

Don't give up on yourself no matter what. Keep the momentum going...!!

My clinic hands out a bright pink sheet with all the questions to ask the insurance company. It states that it is your responsibility to know. But they also verify it.

When I filled out the application it said in big black bold letters it was my requirement to know what my insurance would cover

How discouraging. I'm so sorry you are in this situation, but please don't give up all hope. What about tax returns? Do you get any money back after taxes? I usually don't, but 2 years ago we did and I used that to pay off 1/2 of my expenses as I was all cash pay. What about a small loan? It would be worth it to have the surgery done and know that with each of those payments, you are improving your overall health and mental well being!

Again, please don't give up. There are ways out there, we just have to keep searching to find them. So frustrating that insurances don't cover this when in the long run, it cuts the health issues that they would be paying out for, drastically! Good luck!!

And here's one more idea: maybe Obamacare can step in.....how about finding out about secondary insurance, or using your state's insurance (Obamacare), that may cover you? One thing I have learned in my life is to NEVER NEVER NEVER say NEVER!!!!!!!!! There is ALWAYS a way!!!! You just have to find it, so DON'T give up and proceed looking until you do.

Several options have been listed, and you could even try the thing they do online and ask the general public (bless their hearts, they often give to those who need a procedure, and can't afford it otherwise, for whatever reason). There is ALWAYS a way!!!!!

Now, remember, this may take some time, so DON'T give up while you're waiting, proceed with your plan, continue doing what you have been doing, and SHOW the insurance companies AND your doctors you are serious about this...it may be the key to getting your surgery. Dedication to the program shows ALOT!!!! The most important thing is to NOT give up on YOU! You are too important to let self-pity take over, and you are too strong to cave! Hang tight, my friend, and all will work out. Have FAITH!!!!!!

And a P.S. ......... All this time you have been working so hard, that time may just be enough to get you past the wait-time some insurance companies demand, IF you can show it is documented by your previous doctors. Make sure you get IN WRITING all documentation, they should have kept records showing your progress and in what time-frame. Best of luck to you!!! Keep us informed!

My insurance (through work) doesn't cover it, so I signed up for my husband's for a year. (Added cost of premiums about $3000). They became my secondary insurance, and they paid for my surgery. I will drop that insurance, and will pay for my one-year follow up myself. Still saved 1000s of dollars though.

Whatever happens please don't let this setback lead to other ones...i.e., letting go of the great progress you have made without surgery. I would say keep on this course, and either get an insurance that covers it or go to Mexico, and when you finally get it, the prospects of meeting your goals with it will be that much greater.

Jerr-bear,

I am so sorry! What a disappointing finding, and you are right: infuriating. The others have given some good advice about looking into other options (self-pay/Mexico) and also about documenting your current weight loss.

Whatever happens, don’t use this as an excuse to give up on yourself. Keep up those amazing weight loss efforts – 60 lbs. is proof that you’re able to be disciplined and you’re really dedicated. Try not to look back and regret what might have been. Just look at what is and what WILL be if you keep working hard.

Good luck. I am sorry you had such bad luck.

Sorry for the news as @@SaraSleeves said try and consult with the Nicholson Clinic.