New and need Insurance advice

Megand · December 30, 2010

I am 36 over 300 lbs with hypertension, hypothyroid, asthma, and PCOS. I have Aetna insurance and when I called to see what they cover they said no to bariatric surgeries. I have been told that you can fight your insurance but I have no idea where to start. I have not attended any seminars yet as I just made the decision to look into lap band surgery. I did however purchase the new book is lap band surgery for me. I have my obgyn suggest this about 2 years ago and at the time the insurance said they don't pay so I did not push the issue. Well now I need to fight for my life. I just can not afford self pay as I was unemplyed for a year and my credit is awful now. Anyone who has been through this I would appreciate any advice. If you would rather email me privately my email is cakinqueen@yahoo.com Thanks!

Dave_NW · December 30, 2010

You may want to contact a good WLS clinic or hospital in your area, and ask to speak with their insurance coordinator. That would be the person who deals with insurance companies the most, and who may be able to help you sort through some of the paperwork required. It may be easier than you think to get approved.

Good luck!

Dave

mattie7632 · December 31, 2010

If it's not a covered benefit on the policy there's nothing you can do--it's not a benefit. However, if it's a benefit covered when medically necessary --and you need approval for the surgery, a good surgeon's office will have staff that knows exactly what requirements are needed to do the surgery. First, find out if it's a covered benefit. If it is, find a good surgeon that takes your insurance, make an appointment and speak to the staff about what your financial obligations would be. Good Luck