Ozzy&OdiesMommy

I finally made up my mind to explore the lap band proceedure. I have an appt with my GP next week to discuss how to proceed and who he recommends as a surgeon. In doing some leg work for this I called my insurance company (Anthem). They said that NO bariatric surgery, regardless of the reason is covered. I am absolutly devistated. I can't afford this without help from my insurance company. Even with the maximum flexible spending allowance next year. I have a friend who had this done and she has been a wonderful resource, but she paid out of pocket for her surgery. So she isn't able to help me very much with insurance. I just need help trying to figure out what to do next. I have been looking around these boards and see things about first denial and legal rights. I'm just not sure how and if any of it applies to my situation. Any advice is SO appreciated. :think Ryan

I'm in KY. I think I can purchase a plan as well. I just need to figure out the best way to go about it. I have wonderful insurance through my husband's job, except the lap band proceedure is excluded. Can I get secondary insurance to cover me, or would I have to cancel with my husband's insurance. Thanks!

Well that sucks! My husband was just reading things to me last night out of the information they sent us. So, I didn't actually look at the coverage. I'll figure something out. Someone on the General board suggested a DR in Denver. That might be worth looking into. Thanks again!

Oh! That's a good idea too! Hey I was born in Covington, LA. Are you from around there? My family lived in Folsom.

I found out today that my insurance company excludes weightloss surgeries, no ifs ands or buts. No first denial, appeals or anything. Just not even an option. So, I guess the question is, how do you plan to pay for this surgery or how did you pay for the surgery? I need ideas and suggestions. Thanks all!

Thanks Alexandra. When I talked to the insurance company yesterday it said that no bariatric surgery was covered whatsoever for any reason. But in looking at the benifits package last night they do offer coverege for weight loss programs. Do you think that's worth exploring? Could lap band surgery be considered a "weight loss program"? It said it can cover gym memberships, excersise equiptment and other things. I guess it kinda chaps my @ss that insurance would pay for that stuff (which I've already tried and paid for out of my pocket) and they won't pay for a surgery that is more likely to be effective. Oh well. I guess I need to try and look into the "weight loss program" option. See if I can force it through there? THANKS!

Thank you so much. I agree that if you want it bad enough you will make it happen. And I want this pretty badly, so I am set to do what I have to. Like I said in an earlier post, I was pretty devistated yesterday, but after a good nights sleep, I'm ready to figure out how to make this work.

I think I read somewhere that you can deduct the medical expense on an itemized tax form too. All things to consider. Thank you so much!

Thank you so much. That is a MUCH more doable option. I have a great flexible spending account too. So, fills may be doable locally. I'll have to research that. I'm also in Kentucky, so seeing that there was a patient from KY gives me a little bit of hope. I'm feeling much better about all of this since I got a good nights sleep last night. My 3 month old actually slept through the night. YAY! My FIL works in Denver very frequently too. I'm so happy that a Dr. feels strongly enough about this that he is trying to give an alterntative to going out of the country for this! Thank you, thank you, thank you!

How was your experience in Mexico? I'm a little leary of going to Mexico. Who does your fills now? Thanks!

Thanks! I'll look into that. My husband is really against financing though. Maybe it will just take some time for him to warm up to it.

My husband would NEVER let me go to Mexico! He's too worried I'd die! He won't sign the back of his license for organ donation becase he thinks they will kill him for his organs. Geez!

I honestly think the would just as soon have us die! But that's a really bad attitude to have. So enough of that! I just hope I can get some ideas on how to either get insurance to pay this or another way of paying for it! I just feel like I have no other options left. I'm so sick of the yo yo. Its not healthy. I loose a weight and then I gain it back plus some. Its just time for it to stop.

Thanks for your reply. I feel so hopeless right now. I am in the foulest of moods. I just don't know that I am going to have another option like that. My hubby's company only has Anthem coverage. I feel like I've been kicked in the chest. I finally made this monumental decision to try and move forward with WLS and then this! There is no way that I can pay out of pocket for it. That's what is so frustrating. Do they want to pay for me to have a heart attack. It just makes no sense. Ok, enough of the pitty party. I need help with what my next move is. Any advice would be SUPER!! Thanks so much!

Ugh! I'm in for a long haul I think. My husband's job offers 3 different plans. We have the best one and it still excludes it. So, I'm with you, can you purchase private insurance to cover it? Thanks SO much for your response!

But is my husband's job the one who is setting the exclusions on the policy? Thanks!

I'm confused about this. I called my insurance company today to see if they would cover this surgery. The insurance is through my husband's work. There is an exclusion on the coverage for ANY bariatric surgery. Is this something a company intentionally excludes? I'm interested too to find out if you can purchase your own coverage for this. Thanks!

I just called Anthem today and found out that any bariatric weight loss surgery is excluded from my policy. Is it the employer that determines if its excluded or not? Just wondering. Thanks!

This link isn't working for me. Has the web address changed or something? Thanks! Ryan:help: