This_IsMyRIHality 7 Posted June 29, 2016 Hey loves, My name is Alexandria and I am currently looking into getting the Gastric Sleeve Done. I've struggled with weight all my life, and now at 26 I currently have diabetes along with high blood pressure. Hell, I may even have sleep apnea (going to my first appointment for that next week). Since I've been looking into getting the surgery done, I contact UHC to see if my plan covers it. Unfortunately it does not via my employer. I'm so upset and honestly just bummed out. The agent that i was speaking to a UHC told me the surgeon could write an appeal if they feel that its detrimental. I've been doing a lot of research, and I've seen so many people say "You can't appeal coverage, if its not covered because of employer." Is this true? If so, why would the agent advise me of that? I've also seen how people have talked to HR to see about adding it to the plan. HOW long can this take? I haven't even went to the seminar yet and I'm already stressed OUT! Everything runs about $19,000 here in Oklahoma City. HELP!! lol Share this post Link to post Share on other sites
nerd_is_inferred 13 Posted June 29, 2016 Hi there! I am in the same boat and I've chosen to have my surgery done in Mexico. The cost including airfare will be around 6k. I have UHC here in GA, and it is not covered . Share this post Link to post Share on other sites
garciagiss 23 Posted June 29, 2016 Hi, I was in the same boat as you a couple of months ago ... My insurance through my provider specifically stated that any type of weight loss surgery or consultation is not covered... I even went to HR and asked why?! They said because of the cost .... I sat on my decisions for months. I even applied through a company called prosper for a loan to get the surgery and they wanted to charge me an interest of 30%... Anyways don't give up! A couple of months later I applied with a credit union and got approved at a much lower rate.. I went to Mexico for my surgery and it was the best decision I have ever made . I'm only two weeks out but my experience with Mexico was wonderful! Good luck and don't give up xox Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
ridgerunner 115 Posted June 29, 2016 If you are willing to travel a little Roller weight loss center in Fayetteville, Arkansas does self pay for way less. Share this post Link to post Share on other sites
Sparkles!! 77 Posted June 29, 2016 Like many of the other ladies here, I've chosen to go to Mexico because My employer didn't cover it either. I'm currently on day 4 of my liquid diet, and I fly out in exactly one week! I'm looking forward to doing this and finally getting a stamp in my passport :-) I'll admit that Mexico wasn't my ideal first option, but once I started to look into things and find a surgeon I felt I could trust, I started to feel pretty good about it. There are some great self-pay options in my area that definitely cheaper than what the insurance would pay, but it would still cost at least $5000 more than my entire trip to Cancun. So I'd suggest exploring your options and see what works best for you! Share this post Link to post Share on other sites
This_IsMyRIHality 7 Posted June 29, 2016 Hi, I was in the same boat as you a couple of months ago ... My insurance through my provider specifically stated that any type of weight loss surgery or consultation is not covered... I even went to HR and asked why?! They said because of the cost .... I sat on my decisions for months. I even applied through a company called prosper for a loan to get the surgery and they wanted to charge me an interest of 30%... Anyways don't give up! A couple of months later I applied with a credit union and got approved at a much lower rate.. I went to Mexico for my surgery and it was the best decision I have ever made . I'm only two weeks out but my experience with Mexico was wonderful! Good luck and don't give up xox Sent from my iPhone using the BariatricPal App where did you go? I'm looking at that idea but family and my partner are not very supportive. They don't want me going to Mexico in fear that something could happen. Aghhhhh smh Sent from my iPhone using the BariatricPal App Like many of the other ladies here, I've chosen to go to Mexico because My employer didn't cover it either. I'm currently on day 4 of my liquid diet, and I fly out in exactly one week! I'm looking forward to doing this and finally getting a stamp in my passport :-) I'll admit that Mexico wasn't my ideal first option, but once I started to look into things and find a surgeon I felt I could trust, I started to feel pretty good about it. There are some great self-pay options in my area that definitely cheaper than what the insurance would pay, but it would still cost at least $5000 more than my entire trip to Cancun. So I'd suggest exploring your options and see what works best for you! who are you going to? Sent from my iPhone using the BariatricPal App Hi there! I am in the same boat and I've chosen to have my surgery done in Mexico. The cost including airfare will be around 6k. I have UHC here in GA, and it is not covered . when are you going? Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
dklentz01983 21 Posted July 1, 2016 Hello there. Im sorry to hear that your bariatric surgery is an exclision on your policy. I work for BCBS and I know all insurances are different. But in my professional opinion I think appealing it would be a waste of your time. Your employer has chose not to cover that procedure therefore no matter how bad you need it it wont be approved. Im so sorry. Sent from my SM-G935P using the BariatricPal App Share this post Link to post Share on other sites
dklentz01983 21 Posted July 1, 2016 (edited) Y'all who are going to Mexico please please do your homework on the surgeon My grandpa did the same thing and never made it home alive. Breaks my heart thinking about it. Sent from my SM-G935P using the BariatricPal App Edited July 1, 2016 by dklentz01983 Share this post Link to post Share on other sites
teacherjen 18 Posted July 1, 2016 Y'all who are going to Mexico please please do your homework on the surgeon My grandpa did the same thing and never made it home alive. Breaks my heart thinking about it. Sent from my SM-G935P using the BariatricPal App I'm so sorry for your loss. Was your Grandpa having weight loss surgery? Who was his surgeon?I've heard outstanding things about the programs for this in Mexico. Sent from my SM-G920V using the BariatricPal App Share this post Link to post Share on other sites
dklentz01983 21 Posted July 1, 2016 (edited) It was a long tim ago. I don't know who his surgeon was. I just don't think they did their research. He was having a gasric bypass. Sent from my SM-G935P using the BariatricPal App Edited July 1, 2016 by dklentz01983 Share this post Link to post Share on other sites
This_IsMyRIHality 7 Posted July 1, 2016 It was a long tim ago. I don't know who his surgeon was. I just don't think they did their research. He was having a gasric bypass. Sent from my SM-G935P using the BariatricPal App I'm so sorry to hear that. I have been doing my research and homework. Share this post Link to post Share on other sites
This_IsMyRIHality 7 Posted July 1, 2016 Hello there. Im sorry to hear that your bariatric surgery is an exclision on your policy. I work for BCBS and I know all insurances are different. But in my professional opinion I think appealing it would be a waste of your time. Your employer has chose not to cover that procedure therefore no matter how bad you need it it wont be approved. Im so sorry. Sent from my SM-G935P using the BariatricPal App No worries, no need to be sorry. It's not your fault. It does make me sad though But i talked to my HR manager. I suggested adding it. we will see how that goes.... I'm pretty sure I will be going to Mexico. I'm not sure how much you know about this, but I spoke with some supervisors here at my job and they have advised that several people here in the call center has done the surgery and our insurance has covered it. she advised that it may be something that they need saying its "for my better health" basically. Wouldn't that be something that UHC would have told me? Share this post Link to post Share on other sites
dklentz01983 21 Posted July 1, 2016 What is your grp/id # i have access to ok policies i should be able to access your pred even though i work in tx. I can see why it denied and what steps you need to take if any. Share this post Link to post Share on other sites
Amurillo04 109 Posted July 7, 2016 Normally you can't appeal if it's an exclusion but many insurance reps are not knowledgeable in the matter. I called three times and every time I got a different answer one lady even saying it is completely not covered because it's "cosmetic". But low and behold I have been approved. It may be best to see a surgeon and speak with their insurance coordinator to see if it's actually excluded. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
MissKate 5 Posted August 3, 2016 (edited) Hi Alexandria!! I'm a bit late to the game, but I'm new to the website and trying to get approved for VSG as well. If you haven't contacted HR yet, the following website provides a TON of ammunition to your case. Most importantly being that Oklahoma is one state that REQUIRE WLS coverage under obamacare [employer, group, and individual plans]. http://www.bariatric-surgery-source.com/obamacare-weight-loss-surgery.html I wish you luck!! Hey loves, My name is Alexandria and I am currently looking into getting the Gastric Sleeve Done. I've struggled with weight all my life, and now at 26 I currently have diabetes along with high blood pressure. Hell, I may even have sleep apnea (going to my first appointment for that next week). Since I've been looking into getting the surgery done, I contact UHC to see if my plan covers it. Unfortunately it does not via my employer. I'm so upset and honestly just bummed out. The agent that i was speaking to a UHC told me the surgeon could write an appeal if they feel that its detrimental. I've been doing a lot of research, and I've seen so many people say "You can't appeal coverage, if its not covered because of employer." Is this true? If so, why would the agent advise me of that? I've also seen how people have talked to HR to see about adding it to the plan. HOW long can this take? I haven't even went to the seminar yet and I'm already stressed OUT! Everything runs about $19,000 here in Oklahoma City. HELP!! lol Edited August 3, 2016 by MissKate Share this post Link to post Share on other sites