Newbie

[Stevee 0]

hey everyone, i'm Stevee. 25 year old female in oklahoma. i am wanting to get the lap band done. i am 5'3 255 lbs BMI 45.5. I do not have insurance yet but i will march 1st, i called united healthcare to see what our coverage is on weight loss surgery and was told "all weight loss options including surgical and non surgical are excluded from coverage." great! wonderful! in an instant all of my dreams were crushed! what are my options now guys? i'm at a loss. i dont know what to do i dont know what to say i just want to cry.

please someone gimme some advice or something.

[ReneBean 3]

Sorry BaybeeG. Insurance sucks.

If you have a 401k - you can borrow against that

If your own your home - you can take out a Home Equity Loan

If you qualify - you can get financing thru Capital One. (and lots of people qualify)

Don't completely give up hope...

Hugs!

[Stevee 0]

i've thought about the option of financing it...but i can only imagine what the payment would look like ya know. i'm so scared that i'm not gonna get to do this

[TracyinKS 7]

First is to find out what your self pay options are close to you., then weigh that against going out of state (Like Colorado, Utah, Mexico) where I've seen packages listed for around 10K.

ON Capitol Ones website, you can click the calculator to find out what your payements would be...... Do a search on this site for other medical financing companies... or heck even go out on google and search.

GOOD LUCK!

[flabuless 18]

Sorry to hear of your disappointing news baybeeg00. :bananapartyhat:

However, where the door closes a window opens...dont give up...press on! Push those doors open. There is ALWAYS a way!

:eek: becky

[Stevee 0]

ok so i emailed the Dr's office that i'm considering for my surgery and told them about what the insurance said. and she emailed me back and said

"If the insurance says it is an exclusion, then they will not pay. The only thing you may be able to do is talk to your human resources department and see if they can change the policy to allow the surgery to be covered. Your employer chooses what is covered and what is not. They may not know that this is an exclusion."

ok so here is my dilemma. i just started working here nov 27th, my benefits won't start til Mar 3rd. if i go talk to them now they are gonna look at me crazy you know? like "really shes been here a month and already trying to change things" so... in ya'lls opinion should i wait til Mar and talk to them.

this sucks so bad! all i could do was cry last night. i just dont understand why companys exclude weight loss surgery when everyday it is saving lives. they say obesity is such a big problem in the US and now there are ways to stop it but they aren't allowing it! grrrrrrr! i guess they'd just rather pay for our blood pressure meds or cholesterol meds or diabetes meds! sh*t or even our funerals! grrrrrrrr i get so mad at this issue! this sounds like something oprah or dr phil should address!!! don't yall think!?

[TracyinKS 7]

From an HR standpoint...(my job).... Yes, they will look at you like your crazy, because changing policy is for the most part a pain in the butt and most likely something that is discussed on a Benefits Committee... (at your corporate level)

This is what I suggest........ start seeing a doc OR start a supervised 6 month diet plan SOMEWHERE.. keep all documentation.....When your benefits kick in THEN talk to your HR department and ask them what the process is for a medical appeal, if they don't know ask them to contact corporate and find out what the procedure is.... (NOTE: you don't have to disclose to the people in HR what you want done.. that falls under HIPPA) Just say that you will be needing a procedure that is most likely not covered and you want to know the appeal process......... Then you might call your company EAP (employee assistance plan) and make an appointment for a counseling session....... talk about your struggles with weight..

Company EAP's are offered everywhere..... Usually a company break room or bulletin board has a poster with an 800 number on it.. what most don't realize that these services are FREE to employees, and you can talk about everything from domestic abuse to Credit counseling... OUR plan is good for the employee AND all their family members... 6 FREE sessions PER incident.... (Meaning that one month you could call for your credit problems, and the next month your teenage daughter might run away)

My point being.......... call the EAP, talk about your weight, GET DOCUMENTATION FROM THE MEETING... (this may satisfy the phyc eval)

Lets face it....... if this is excluded under your policy you are going to have to jump through hoops to win an appeal.......

If all this fails...... appeal with the state insuarance board.... (KEEP MULTIPLE COPIES OF ALL your documentation)

and GOOD LUCK!~

[Stevee 0]

ok so ... ummmmmmm i emailed HR this morning. all i said was that i was inquiring about WLS and that its excluded. i asked her if maybe there was a way that i could pay more for insurance to have it not excluded etc, just kinda told her i'm exploring my options. so lets see what she says!

i'm so ready to fight this! woo hoo! i'm gung ho about this for real! i have 2 months til march! and i wanna try my hardest to get banded in march! thank you so much for your advice! ya'll are amazing!

[juliegeraci 7]

Sorry to hear that. I have UNited Healthcare and they covered 100%. I wonder if I have a different plan than you. Good luck. Its worth it.