Getting Insurance to Cover Surgery

[Sidney2015 0]

I. Cannot get my insurance to cover my surgery. Does anyone have any suggestions on how I can get my insurance to cover my gastric bypass? I have almost all of the criteria for surgery. I appreciate any help you all give me

Edited March 6, 2016 by Sidney2015

[Daisee68 2,493]

Unfortunately some plans just completely exclude it. I am not sure there is much way around it. The only thing I could think of that might even remotely help would be a call from your doctor.

[kjwrn 129]

"I have met almost all the criteria for surgery."

Unfortunately the reason why it is not covered is because you are not meeting their criteria, and until you do, you likely will not be covered.

[pammieanne 269]

So much depends on what your insurance covers to begin with. Do they cover WLS at all? What are their requirements, and what are you NOT meeting at this point?

So sorry, I know that has to be so frustrating!

[checkers749 0]

My insurance does not cover anything related to weight loss but they will cover diabetes, sleep apnea, degenerative joint disease, HBP, and all of the other related illnesses! My husband and I have decided that my health is worth the investment and the WLS center will work with me on payments.

Sent from my iPad using the BariatricPal App

[checkers749 0]

My insurance flat out states that it does not cover anything related to weight loss. It makes more sense to treat obesity rather than all of the comorbidities.

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[kaitlynm 335]

Generally all insurance covers WLS, it is your employer who decides whether or not to include or exclude WLS. More education needs to be given to employers that they will actually save money in the long run by covering it.

You may want to talk to your HR department and push for them to make an exception for you if you can prove they will spend less in the future.

Edited March 18, 2016 by kaitlynm