Devestated!

[mom23kidz 4]

Ok so I went for first consult in OCT have done group diet, EGD, stress test, etc and find out TODAY when I call my insurance to push claims that my plan does NOT COVER bariatric surgery!!!! Found all this out right at 5 so of course surgeon's office was closed already!!! I was counting on my insurance covering this!!!

[lgray 1]

Ask your surgeon if you can call it a henial hernia removal with sleeve gastronomy. That's how I got mine covered. Some Drs and hospitals will work with you in whatever way possible. Never hurts to ask!

[Cupcake 801]

Igray that is an excellent idea I hope that mom23kidz look into your suggestion.

[ChavaBling 145]

Here's what my bariatric program coordinator told me last month: ALL HEALTH PLANS are/will be required to cover WLS per the Affordable Care Act. Maybe try to find out which section of government code this falls under? It would be hard for your ins to argue with you if you can point to a specific section of the law. I hope this works out for yoU!

[Kindle 8,667]

Here's what my bariatric program coordinator told me last month: ALL HEALTH PLANS are/will be required to cover WLS per the Affordable Care Act. Maybe try to find out which section of government code this falls under? It would be hard for your ins to argue with you if you can point to a specific section of the law. I hope this works out for yoU!

Could you ask your coordinator to provide the specific law that backs up her statement? From everything I've read, it's up to the individual states to decide if they will require that their policies cover WLS. I can't imagine how over 2 dozen states (that are not covering WLS) are actually doing so illegally.

[mom23kidz 4]

Igray is that not illegal?

[lgray 1]

Mom23kids no you are still classifying it as sleeve surgery they are just listing the hernia as the number one. It's all about coding with the insurance companies.

[Bluesea71 698]

Here's what my bariatric program coordinator told me last month: ALL HEALTH PLANS are/will be required to cover WLS per the Affordable Care Act. Maybe try to find out which section of government code this falls under? It would be hard for your ins to argue with you if you can point to a specific section of the law. I hope this works out for yoU!

I remember looking into this last year an actually found a screen shot I took on my iPhone about it.

[mom23kidz 4]

Thanks guys I will try anything!!!!

[Bluesea71 698]

Here's what my bariatric program coordinator told me last month: ALL HEALTH PLANS are/will be required to cover WLS per the Affordable Care Act. Maybe try to find out which section of government code this falls under? It would be hard for your ins to argue with you if you can point to a specific section of the law. I hope this works out for yoU!

I remember looking into this last year and actually found a screen shot I took on my iPhone about it.

[ChavaBling 145]

Here's what my bariatric program coordinator told me last month: ALL HEALTH PLANS are/will be required to cover WLS per the Affordable Care Act. Maybe try to find out which section of government code this falls under? It would be hard for your ins to argue with you if you can point to a specific section of the law. I hope this works out for yoU!

I remember looking into this last year an actually found a screen shot I took on my iPhone about it.

:

I live in California, la la land!! It makes sense that it would be left to the states to decide if they require it. OP, my apologies if that was misleading. I don't know where you're located but that's terrible. It should be covered everywhere as medically necessary.

[WhoKnows 288]

Talk to your surgeon before you give up. I was also told by my insurance company that they don't cover it, but then the councilor at my surgeon's office said they always say that, but if you prove it's medically necessary, they can decide to (I sent it my application two weeks ago and I'm waiting for the reply). To be fair, I live in Germany and so I'm not sure how the American system is, but from reading on this forum so far, it seems like things are more similar than they are different. All I'm saying is, talk to the people who deal with this everyday before you freak out.

[mom23kidz 4]

Ok, I plan on calling doc office ASAP .... Not freaking out, that just totally blew me away!!!!

[mom23kidz 4]

Talked with surgeons office today. They said they would not of seen me if my insurance didn't cover WLS, so they are researching it. Prayers please!!! 15,600 is a lot of $$ otherwise!!!!

[WhoKnows 288]

Keeping my fingers crossed for you!