Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

Just got the call from my surgeons office. My insurance does not cover bariatric surgery it's a plan exclusion. What are my options at this point? They said I can finance it and that there are other options. I need advise.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

I went to Tijuana Mexico to the OCC

Although the hyper link will point you to their ad, I did not go there

Edited by IrishGermanRN

Share this post


Link to post
Share on other sites

Was it submitted as a prescribed medical treatment e.g. BMI > 40, diabetes, sleep apnea, hypertension, etc)? or as a weight-loss procedure? If you're not sure, ask your surgeon's office staff to ensure you're being recommended for surgery as a medical treatment/procedure (assuming you're eligible based on health risks and factors). If necessary, ask your surgeon to write and submit an appeal letter to the insurance with additional supporting information (related health issues, your willingness to undergo nutritional counseling, etc). You definitely have appeal options - don't take this first 'no' as a final answer. Good luck!

Share this post


Link to post
Share on other sites

I'm so sorry to hear this. What insurance company do you use, if I may ask?

If I were you, I would take out a loan. I have several health issues and my weight is the only thing making me unhappy. Money is definitely an issue with me, but there is no price on happiness and good health. I'm only telling you what I would do; not what you should do. I don't know what your full story is.

Share this post


Link to post
Share on other sites

@@SoCalBoiler it has not been started yet. So far I have just called to set up consult and to verify benefits. My BMI is 46.8 and I have hypertension. I'm working on finalizing a consult to explore my options further. Not sure what to do with insurance since it is a plan exclusion

Sent from my iPhone using the BariatricPal App

@@Hiraeth I have Aetna choice pos II.

Sent from my iPhone using the BariatricPal App

Share this post


Link to post
Share on other sites

My policy has an exclusion as well. Really, my husband's employer chose to exclude it for financially purposes I would guess. I'm going cash pay. There is no other option for me. Insurance doesn't care if it's medically necessary or not.

Share this post


Link to post
Share on other sites

@@SoCalBoiler it has not been started yet. So far I have just called to set up consult and to verify benefits. My BMI is 46.8 and I have hypertension. I'm working on finalizing a consult to explore my options further. Not sure what to do with insurance since it is a plan exclusion

Sent from my iPhone using the BariatricPal App

@@Hiraeth I have Aetna choice pos II.

Sent from my iPhone using the BariatricPal App

I'm so sorry they're being this way with you. Is there any way you can self pay?

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 1 reply
      1. kezbeth

        I may have to have gall bladder surgery during my weight loss surgery. Not thrilled about it either but do not want 2 recovery times. Just want it over with.

        Thanks for your post. I may need to rethink my decision... :(

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×