Sleeve Plans dashed Insurance issues

[Mr-Smith 7]

Well, to make a long short, due to some documentation issues I can't fix, my insurance company will deny coverage for WLS.

I could keep appealing until it's approved. It may take a few months to a year but doable.

BUT...

My company was just purchased by Manpower and my insurance could switch over to a new policy anytime in the next four months.

So the timing is looking bad right now, I could spend a few months getting approved and then have my insurance change over and not cover it at all or find it is covered and the requirements require less rigor for approval.

Either way, I need to wait. Or fly to Mexico LOL.

-Mark

[Oregondaisy 2,021]

mark, sorry I dashed out of chat last night without a good bye. My grandson hit the button and disconnected me from being online. You were gone when I came back.

I hope you get your ins. problems figured out. If you can afford to go to Dr. Aceves, we all love him!

[youknowit 11]

Perhaps MX is the best bet if you are really trying to get this done. I too could have battled the insurance for who knows how long, only to get UP to $5000 FOR LIFE covered, it wasn't worth it. I say do what you need to do, and don't look back! :smile:

[Barbara278 9]

Mark, sorry to hear about your insurance not covering WLS. It can be devastating to hear that kinda news. Don't give up, just keep working on it and a solution will come.

[Garyb_58 1]

Mark,

Sorry to hear about the problems but they sound very familar to

me. My company changed insurance companies three times in early

2008 while I was doing the test needed to get approved for WLS.

Needless to say we ended up with United Health Care and they will

not pay for anything that has to do with WLS.

I decided to pay the surgery with a loan off my 401k and flew to Mexico.

Dr. Aceves and his staff were great. I was lucky to find local people

who had used Dr. Aceves as well as everyone speaking highly on this site

about him.

You have to make up your mind, but don't let Mexico scare you. My surgery

was 1-25 of this year and I have dropped 8 pound pre-op and 23 pounds

post-op. Loving the sleeve.

Have a great weekend.

[Oregondaisy 2,021]

I second that! Dr. Aceves is a fabulous doctor and I was thrilled with the care he and his staff gave me, along with over half the people on this board!

[cajun 46]

I agree. My insurance would not cover it so I just saved up and went to Dr Aceves. It was so much simpler than jumping through insurance company requirements anyway.

Dr Aceves' program is fantastic.

[carolyn24seven 11]

I agree with all of the above. I could have used my Ins deductable of 7,500 here (in SoCal) but the plus 20% put it out of range. I opted for mexico and the cheepest at that. From all that I have read on here I would suggest for you to go to Dr. Aceves. His is a more complete sounding program. I tell anyone who asks me that.

Because, even though I had a very successful non-eventful surgery with Dr. Alvarez at the "emmanual" clinic, there is no guarentee that will happen for you. The person in the bed next to me did not have a good outcome. I have not seen any adverse reports out of Dr. Aceves group of patients.

I am a very happy sleever. I also think I got lucky with my choice.

Good luck to you.

[thinoneday 445]

Well, to make a long short, due to some documentation issues I can't fix, my insurance company will deny coverage for WLS.

I could keep appealing until it's approved. It may take a few months to a year but doable.

BUT...

My company was just purchased by Manpower and my insurance could switch over to a new policy anytime in the next four months.

So the timing is looking bad right now, I could spend a few months getting approved and then have my insurance change over and not cover it at all or find it is covered and the requirements require less rigor for approval.

Either way, I need to wait. Or fly to Mexico LOL.

-Mark

I'm sorry this has happened to you. . . that is always so disheartening, have you thought about self pay? I got my loan from the bank at 3.7% . . . not too shabby and you don't have to wait for all that rigamaroll that insurance companies demand. . . just a thought

[Mr-Smith 7]

All, thanks for the reply.

I need to see what happens when the dust settles from this merger and evaluate from there.

MX is not off the table

Mark