touchick156 1 Posted July 5, 2016 Just got the call from my surgeons office. My insurance does not cover bariatric surgery it's a plan exclusion. What are my options at this point? They said I can finance it and that there are other options. I need advise. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
IrishGermanRN 151 Posted July 5, 2016 (edited) I went to Tijuana Mexico to the OCC Although the hyper link will point you to their ad, I did not go there Edited July 5, 2016 by IrishGermanRN Share this post Link to post Share on other sites
touchick156 1 Posted July 5, 2016 Not wanting to go out of the country, a bit outside my comfort zone but thank you for the suggestion. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
JennAsVSG 1 Posted July 5, 2016 Sorry to hear that hoping you can find another way! Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
SoCalBoiler 23 Posted July 5, 2016 Was it submitted as a prescribed medical treatment e.g. BMI > 40, diabetes, sleep apnea, hypertension, etc)? or as a weight-loss procedure? If you're not sure, ask your surgeon's office staff to ensure you're being recommended for surgery as a medical treatment/procedure (assuming you're eligible based on health risks and factors). If necessary, ask your surgeon to write and submit an appeal letter to the insurance with additional supporting information (related health issues, your willingness to undergo nutritional counseling, etc). You definitely have appeal options - don't take this first 'no' as a final answer. Good luck! Share this post Link to post Share on other sites
Hiraeth 515 Posted July 5, 2016 I'm so sorry to hear this. What insurance company do you use, if I may ask?If I were you, I would take out a loan. I have several health issues and my weight is the only thing making me unhappy. Money is definitely an issue with me, but there is no price on happiness and good health. I'm only telling you what I would do; not what you should do. I don't know what your full story is. Share this post Link to post Share on other sites
touchick156 1 Posted July 5, 2016 @@SoCalBoiler it has not been started yet. So far I have just called to set up consult and to verify benefits. My BMI is 46.8 and I have hypertension. I'm working on finalizing a consult to explore my options further. Not sure what to do with insurance since it is a plan exclusion Sent from my iPhone using the BariatricPal App @@Hiraeth I have Aetna choice pos II. Sent from my iPhone using the BariatricPal App Share this post Link to post Share on other sites
MarieLouise 31 Posted July 5, 2016 My policy has an exclusion as well. Really, my husband's employer chose to exclude it for financially purposes I would guess. I'm going cash pay. There is no other option for me. Insurance doesn't care if it's medically necessary or not. Share this post Link to post Share on other sites
Hiraeth 515 Posted July 6, 2016 @@SoCalBoiler it has not been started yet. So far I have just called to set up consult and to verify benefits. My BMI is 46.8 and I have hypertension. I'm working on finalizing a consult to explore my options further. Not sure what to do with insurance since it is a plan exclusion Sent from my iPhone using the BariatricPal App @@Hiraeth I have Aetna choice pos II. Sent from my iPhone using the BariatricPal App I'm so sorry they're being this way with you. Is there any way you can self pay? Share this post Link to post Share on other sites