Crushed...

[ravenjeh 0]

I just called my insurance company (BC/BS of MS) and was told that they do not cover any type of bariatric surgery or treatment. I then asked what if I appealed and the doctor deemed it medically necessary and was told that no it would get denied and probably would get stuck with the bill afterwards. I have no idea what to do now... so upset. You would think that the most obese state in the US would definitely have coverage for this :confused:

[Banded_Lady C 0]

I am so sorry to hear this. i am still waiting on my insurence to let me know if this type of surgery is covered.

[Shay7997 0]

I am so sorry The only thing I can think of is to look into the self pay options. I know Care Credit is something often talked about on here.

[Bryn 3]

Oh no, I am sorry to hear this. Try and get your doctor to write to the insurance company on our behalf, you never know; maybe after the doctor submits it they may cover some. Or look into financing options. Don't give up!!

Good luck

[Wimic 1]

When I was initially reading up on this procedure it seemed like everyone was getting it done through either through government funded programs or by their personal medical insurance. I checked with my medical insurance company and they said the same thing... that it isn't covered. I really (REALLY) had my heart set on getting it done so I've opted to foot the bill myself. I took out a $25,000 line of credit and am going to pay it off that way. The procedure itself is $16,000, the flight is around $800 and the hotel is around $500. It's an expensive endeavor, but I know it'll be worth it. On the bright side - having to pay for it your self (and make payments every month) is a constant reminder of the committment you made to yourself. I would pay A LOT more than that to lose the weight once and for all and if you're serious about making the committment to change, it really is a small price to pay.

[BetsyB 9]

Insurance only provides the coverage an employer purchases; if you want to have the coverage, making a case with the insurance company is futile. The place to start is with the benefits person at your (or your spouse's) place of employment. You can make a pretty strong case in favor of purchasing coverage for bariatric surgery when you identify the costs related to obesity (and health care related to obesity) for the employer.

Every insurance provider has a whole spectrum of different coverages---and employers choose which to purchase, largely based on cost. If their employees demand other coverages, however, they may opt to include them when they renew policies.

[ravenjeh 0]

You're right, Betsy; I was told that my husband's employer was responsible for choosing what and what not to be included. So, I guess I can't really be mad at the insurance company.

So, this is my plan B, lol. I was thinking that maybe I could drop my coverage on my husband's plan and get my own individual policy through another company (maybe Aetna?) that is more likely to include the surgery. Has anybody done this? Any thoughts??

[bayareanan 24]

Sorry to hear of your bad news. The same thing happened to me last year. I was crushed to as I had done the 6 month supervised diet before I found out.

In January work changed it's insurance carrier which now covers the surgery. I am in the process of getting my paperwork together so I can get the surgery done before year end.

Dont give up.

[Sue Magoo 71]

You're right, Betsy; I was told that my husband's employer was responsible for choosing what and what not to be included. So, I guess I can't really be mad at the insurance company.

So, this is my plan B, lol. I was thinking that maybe I could drop my coverage on my husband's plan and get my own individual policy through another company (maybe Aetna?) that is more likely to include the surgery. Has anybody done this? Any thoughts??

Be careful when selecting a new insurance company. In addition to making sure they cover band surgery, make sure that they don't exclude preexisting conditions.

Good luck!

Sue

[Nangr 0]

I know how you feel. My insurance doesn't cover Lapband. I'd have to pay the $17,000 bill. I'd have to take out a loan. I don't know what to do. It's so expensive.

[ravenjeh 0]

I know, Nangr. I so cannot afford a huge loan payment, not that it matters because I got denied by credit care anyway due to my credit history. The only program I have not tried is a medically supervised one, like HMR. So I'm going to a seminar on it tomorrow. Probably can't afford that either, lol. Soooo discouraging

[amandac82 0]

I am so sorry to hear about your troubles!

Have you considered going to Mexico. From the advertisements I've seen alot of times it can be done for around $4500 plus cost of flying. That's not a huge amount and maybe can be borrowed from a family member or friend. Or maybe someone could co-sign a loan for you. Just a thought.

DONT GIVE UP! This is YOUR life. You deserve to live it.

[stateofzen 46]

Sorry to hear of your bad news. The same thing happened to me last year. I was crushed to as I had done the 6 month supervised diet before I found out.

In January work changed it's insurance carrier which now covers the surgery. I am in the process of getting my paperwork together so I can get the surgery done before year end.

Dont give up.

This is exactly what happened to me too. I switched to my husband's insurance off of mine (the exact same insurance company- we just had different plans), and am now getting covered through his insurance.

It means that this is happening about a year later than I had initially planned, but hey, it's happening and I don't have to take out a loan!

[twyla420 0]

Our insurance didn't cover the band, but because I had a hernia...it covered that part of the surgery and I am paying off the band. To make a long story short...insurance paid for about half...so I'm paying off the rest. If you have acid reflux you may want to see if you have a hernia. It's all in the way they code it.

[Nangr 0]

i do have acid reflux. that might be a choice. thanks