Insurance Won't Pay!

[egrazz 5]

Well boo-hoo, just found out my insurance won't pay! What a disappointment.; Now to figure out if I really want to shell out $10,000 for the surgery. I know my health is more important than $, but that's a big chunk of change to let go of even if you have it! :/ Lots of soul searching to be done this weekend!

[ladytru84 23]

Sorry to hear that have u tried to fight it

[egrazz 5]

Not sure I can. The girl at True Results said there is an exclusion by the employer for no Lap Band Surgery.

[bluetigereyes 95]

Talk to the HR Rep for your employer. They can CHOOSE to have Bariatric benefits for their employees. If you tell them that in the long run, you will be healthier, have less sick days, be in better physical and mental health, that may change their mind on what services they choose to cover for their employees.

[xavier 153]

Mine was a matter of BMI and I didnt think I could gain 25-30 pounds to get it paid for (I mean it would have killed me emotionally not knowing if the lap band would even work for me!). I am still so mad at my lousy insurance co! Plus I had no comorbidities.

Now I am normal BMI and normal labs etc and I feel like they should be kissing my feet! But I would do it all over again...my huz always says what a cheap date I am now in terms of food and drinks...

[flab u less 45]

I am self pay. I am being banded on the 19th. Its worth it! I have insurance too. But didn't want to gi through then months of hurdles and maybe a denial after that. This is ur life,when ur car failsnwendont think twice in investing in a new car.. this is your health,your life... don't think twice!,,

[egrazz 5]

I am self pay. I am being banded on the 19th. Its worth it! I have insurance too. But didn't want to gi through then months of hurdles and maybe a denial after that. This is ur life,when ur car failsnwendont think twice in investing in a new car.. this is your health,your life... don't think twice!,,

That is very true! My husband and I had a long, long talk about it last night and I am going full speed ahead!

[Back~To~Amy 307]

That is great to hear! After being told I had great coverage for WLS, I found out that is not the case. I have coverage, but the coverage is so bad it would cost me more to use it then to pay the self-pay prices. I've pretty much convinced myself to do it, but darn it is so hard to spend that much money!

[flab u less 45]

I am self pay and have borrowed and got a loan to get this. I have said this before and think that if my car went dead and was unfixable I would have to get a new car right? So u r worth it for ur body.so u can have a functional healthy body that u can take care of for a long time. Or u can keep trying to get the lemon of diets doing this and that and ur body still stresses because of the up and down in weight shifts! Don't think about it twice! U r worth it. And I know I am too..

[egrazz 5]

Good luck today flab u less!

[dhales 98]

Not sure I can. The girl at True Results said there is an exclusion by the employer for no Lap Band Surgery.

What True Results are you going through? I am going through True Results in Houston and they have a hernia/lap band program. If you qualify the insurance will pay for a portion and you will just be responsible food $5500 which can be in house financed. I think it comes out to $270 a month for 2 years. I didn't really have symptoms of a hernia but paid $80 for the EGD and I had one...a tiny one...but it qualifies! I was happy to hear that I had a hernia...lol Apparently many overweight people have a hernia and may not know about it. It's worth checking out....

I also wanted to mention that my employer had an exclusion as well. I have UHC.

[Joyce Real 21]

Same deal here, my company does not have that as an option in their insurance, but in the long run, self pay was much easier, without having to jump through the insurance companies hoops. I just paid and had surgery, no pre op stuff except an ekg and egd which my insurance did cover.

[egrazz 5]

What True Results are you going through? I am going through True Results in Houston and they have a hernia/lap band program. If you qualify the insurance will pay for a portion and you will just be responsible food $5500 which can be in house financed. I think it comes out to $270 a month for 2 years. I didn't really have symptoms of a hernia but paid $80 for the EGD and I had one...a tiny one...but it qualifies! I was happy to hear that I had a hernia...lol Apparently many overweight people have a hernia and may not know about it. It's worth checking out....

I also wanted to mention that my employer had an exclusion as well. I have UHC.

dhales, I am going through True Results in Hurst, Texas. Sorry it took me so long to reply, I haven't been around for a few days. I had my consultation yesterday. Everything is moving right along. The surgeon's office is supposed to be in touch with me by Monday to schedule my meeting with him and then surgery will be scheduled. I am hoping for the middle of April. I was very impressed with the staff at TR, everyone was very informative and so nice. I feel good about my decision to go with them.

[Boniluuu 25]

See if there is a true results near you. They will help you with the cost. My insurance has no weight loss coverage.

[shellbug78 0]

I am in middle Ga and was just denied by my ins for the 3rd time. This means I can't appeal again. My Dr.'s office says they don't have a hernia repair/lap combo that would lower the costs. Does anyone out there know of anything else that could help? I was denied because my BMI went to 33 in 2009. So, according to BCBS, I haven't been consistantly fat enough. I can't handle it!!!!!