2016NewMe 61 Posted September 14, 2015 What should I do if I already now it's bot covered at all in my PPO insurance? Share this post Link to post Share on other sites
Margie122 845 Posted September 14, 2015 If you know for certain that bariatric surgery isn't covered by your company's health insurance policy you can write to HR and ask them to get it covered at the next renewal. There was a letter I saw on these boards that someone created just for that purpose. I'm pretty sure he said it could be copied and pasted. You might want to search for it. Your other option is self-pay. There are a lot of doctors who do this surgery and the rates vary in different parts of the country. There is always the Mexico option. Again - there are a lot of people on these boards who have self-paid and you could search for that info on these boards. Can you switch health insurance next year? Is there a policy you can get at work that covers WLS? The only other option is finding a new job with insurance that you know covers it. Best of luck. Share this post Link to post Share on other sites
2016NewMe 61 Posted September 14, 2015 Thanks I will look in to that Share this post Link to post Share on other sites
Bean80128 80 Posted September 14, 2015 Also, a lady I work with was told by her surgeon that even though it is specifically excluded from her policy, if it is "medically necessary" sometimes they will cover it. The surgeon likely would have to do some extra work to convince the insurance provider of the necessity. Share this post Link to post Share on other sites
2016NewMe 61 Posted September 14, 2015 Thanks bean80128 you've given me a little hope my primary doctor that got me into this process also told me this right now so I got my hopes up a little hopefully it's goes well for me Share this post Link to post Share on other sites
ThreeFifty 166 Posted September 14, 2015 Some people might not like this idea depending on where you fall politically My insurance didnt cover WLS so I signed up for the affordable care insurance (not sure what its called....obamacare) I didnt get any discount as I think you have to make under a certain amount a year before the discounts kick in and I was over that. so I just got the value blue plan I think its called. I have to pay a monthly fee, and I have a high deductible. But it got my surgery done and I'm only keeping it for a year. You'd have to wait till the end of the year for the next enrollment period, it will cost you a bit of money, as the monthly fee is hi, and the deductible is high. Cheaper than paying outright, more expensive than going to Mexico. Share this post Link to post Share on other sites