My insurance is saying lap-band is excluded!

mommy2kyler · June 22, 2007

I am so freakend disapointed. We pay $80 a week for our stupid insurance and they wont even pay for this surgury that i REALLY need. I am only 5 feet and weigh 250 pounds. How can this be right. I am so upset!!:think:heh::faint:

Alexandra · June 22, 2007

Unfortunately, if you have a large-employer plan and the employer has chosen to exclude all bariatric treatment from the policy, there is very little you can do. If there is a more specific exclusion, such as exclusion of banding but not RNY, you might be able to appeal that on the grounds that it's preventing a preferable treatment. But if your employer has the right to design its own policies and its chosen this route to save money, you may be at their mercy.

Take a look at your contract and see how the language reads. Then check with your state's department of health or insurance (whichever one has jurisdiction over health insurance plans) and see if you have any recourse. Good luck!!

SJB · June 23, 2007

I have state employees' insurance and it specifically excludes weight loss surgery. It really stinks to me that I have to pay for part of my insurance coverage, but it didn't pay for this. (And what really bites further, is that my tax dollars are being used to pay for folks on medicaid and medicare to have their surgeries!) I guess I am just petty, but it just doesn't seem fair. I had to have this done as a self-pay patient. If it is any help to you, Allergan has a patient financing plan available.