Insurance question for college aged person

Barbiedollgirl · April 17, 2007

Hello everyone. I am Barb from Oregon. I have worked at the Good Samaritan Hospital(for 19 years) here in Portland that is the National Institute of Health's center for excellence for bariatric surgeries. We have insurance coverage for the bariatric surgeries. However, it only covers person over the age of 25. I joined this site to try to get help for my daughter who has decided she would like to have the surgery. Does anyone have words of advice for me on trying to get our insurance to cover her surgery? I will try to appeal approach and have already emailed our VP. I heard there was a lawyer out there that works for the lap banding manufactor that helps people who have insurance problems. Any suggestions or ideas would be greatly appreciated! Thanks alot! Barb

anonemouse · April 17, 2007

Since there is an exclusion in the plan, I don't think you'll have any luck wrangling with insurance. There's always Mexico, though, or some of the cheaper US surgeons, like Dr. Kirschenbaum (or however you spell it) in Denver.

faithmd · April 17, 2007

Hello everyone. I am Barb from Oregon. I have worked at the Good Samaritan Hospital(for 19 years) here in Portland that is the National Institute of Health's center for excellence for bariatric surgeries. We have insurance coverage for the bariatric surgeries. However, it only covers person over the age of 25. I joined this site to try to get help for my daughter who has decided she would like to have the surgery. Does anyone have words of advice for me on trying to get our insurance to cover her surgery? I will try to appeal approach and have already emailed our VP. I heard there was a lawyer out there that works for the lap banding manufactor that helps people who have insurance problems. Any suggestions or ideas would be greatly appreciated! Thanks alot! Barb

If it is an exclusion for folks under 25, you will have a very tough, if not impossible time.

try www.obesitylaw.com

He does not work for the manufacturer, I am not sure who that would be, but Walter Lindstrom is a reputable lawyer who for a few hunderd dollars will write a good letter for you and help guide you through the process.

skyeblu79 · April 18, 2007

I am a college student and my insurance had an exclusion for lap band surgery for everyone. I ended up taking extra loan $$ to hlep pay for the surgery. Not sure if you daughter is undergrad or grad, but as a grad student you can get a lot more loan $$.

How far is your daughter from 25?

Good luck!!

Barbiedollgirl · April 18, 2007

Thanks for the advice! My daughter will be 20 in June. I don't think we can take out another $20,000 in loans to have the surgery and my husband will kill me if I second mortage the house (he's skinny and doesn't understand). I have emailed the lawyer asking for advice. At work we are getting ready to decide our benefits for next year and they are taking surveys to see what people want. I will do the survey and I have all my friends do the survey too on my daughter's behalf. I work for the hospital that does these surgeries. Our surgeon has been meeting with our VP to see about changing the age exclusions, but nothing will probably happen this year which is okay since we have to see the dietician and be followed by him/her for 1 year according to our plan. Good luck everyone and thanks for writing! Barb in Oregon

:phanvan

faithmd · April 18, 2007

Thanks for the advice! My daughter will be 20 in June. I don't think we can take out another $20,000 in loans to have the surgery and my husband will kill me if I second mortage the house (he's skinny and doesn't understand). I have emailed the lawyer asking for advice. At work we are getting ready to decide our benefits for next year and they are taking surveys to see what people want. I will do the survey and I have all my friends do the survey too on my daughter's behalf. I work for the hospital that does these surgeries. Our surgeon has been meeting with our VP to see about changing the age exclusions, but nothing will probably happen this year which is okay since we have to see the dietician and be followed by him/her for 1 year according to our plan. Good luck everyone and thanks for writing! Barb in Oregon
:phanvan

Start seeing the dietician now. Your PCP can set that up, and considering your daughter is overweight, that could be covered. Have the PCP not say anything about the desire for surgery later. Do everything you can to get whatever requirements you have, or could potentially have, out of the way.

Good luck!