What is next?

[SCTexasGirl 0]

Okay so the BCBS that I have does not cover any bariatric anything. I had my band done under insurance through my last job. I lost my job, went on my husbands ins, he switched jobs and now we have BCBS again. You would think that they would still cover bariatric conditions if you were covered before. I wrote an appeal letter. They said that they would cover pre existing conditions. I called them and they said that because of the place my husband works for has an exclusion for bariatric treatment at all, that is not concidered a pre-existing condition. What do I do now??????? I am so lost and I don't know where to go from here. My Dr wants this thing out because it is not working and they don't want to do it. He wants to do the sleeve while he is in there and they won't do that either......I truely hate insurance cos! So what do I do now?

[TexasT 99]

I was self-pay for both band and sleeve. Paid for the band by getting a home equity loan. The interest rate was lower than other options, plus you can write off the interest on your taxes.

My revision to sleeve was partially covered by insurance because I had my gall bladder out at the same time. My doc charged me $5000 for the removal of the band and VSG. I did it at the first of January, claimed the surgery fee on my "FSA plan" (or whatever they call it now) at work, where they take money out of my check tax free each paycheck. Used all mine and my hubby's for the year ($4800). So basically, I'm paying $400/month for the revision by having it deducted from our paychecks. We would have had this taken out anyway and used it for meds and any other medical expenses for the year, so I don't feel like I'm missing it.

[MINI-Me 196]

What type of issues are you having with your band. If you can show that it is causing serious physical issues, you may have a case for them covering the removal.

Since WLS is not covered by your current plan (a choice made by your husband's company, not the insurance company) you will have to pay for the sleeve yourself. However, since there is already OR and surgical time for the band removal, etc, you can negotiate with your surgeon for a much lower cost on the sleeve.

Best of luck!

[MlkPas 5]

It's not the insurance company's fault. Your husband's employer decided not to offer a WLS benefit to its employees. Its choice, not the insurer's.

Seems like you have two choices: Pay for the sleeve yourself (like many of us here did), or find a job yourself that offers bariatric insurance benefits.