New and Dissapointed :(

[reachbree 140]

Hi all, I went to see my doc regarding the LB surgery and she said she was pretty confident that she could get me approved as she was good at doing all the paperwork and whatever was needed. Little did she know my insurance (aetna) would cover the surgery after exceptions, which was fine, even though I am healthy, my doc was not worried and said she knew how to get it covered...BUT my employer will not cover it.

Gee thanks job.

I HATE my job right now. Ive been here for 5 yrs and had I known 5 yrs ago that I wanted this surgery and they did not cover it, then I probably wouldnt have taken the position, as I had other offers at that time. This SUCKS, and at 231lbs, 5'2,....I need to loose weight badly.

This is the response I got from my employer:

We have looked into this procedure and determined that due to the serious risks and complications with this treatment, it will not be covered under our plan. Sorry.

Edited February 19, 2009 by reachbree

[mljalways 1]

I am so sorry to hear that. Although I got my surgery in the end I too had a dissappointment of being told no. Keep the faith and something good will come. Good luck

[kelli130 0]

My employer had the same clause added to our group coverage. Well, screw them. I went through care credit and paid for it myself. I decided I wanted it and didn't have to jump through all the insurance hoops. I had my surgery within 5 weeks of making the decision. I was banded on December 10th. I have lost about 25 pounds and feeling great. It has been worth every penny!!!!!

[twofeathers710 0]

I know how you feel my company has the same clause. I went to my HR person. She had me to get together some facts about the lap band and a list of all the diets I have tried in the past and failed. With all the info I got together she helped me put together a letter to summit to my employer. To ask them to lift the clause and give me a chance to make my health better. She thinks they will approve it. GOD I hope so. I have been waiting for about 2 weeks to hear back from them. She told me it will take some time. The wait is killing me.

Maybe you can try to do the same thing. Ill let you know what happens in my case when ever I finally hear.

God will make a way.

[ait 0]

My employer also added lap band coverage this year. Talk to your HR and talk to your benefits manager and see if they could think about adding.

Good luck!

[Fluffy_Gurl 3]

I had the same issue also. I was told that it was covered during open enrollment so i of course got the more expensive plan because it had beter surgical coverage etc and had a lower deductable for the surgery however when i went to get it approved i was old that my employer had decided not to cover any weightloss procedures or programs not even nutritional counsling...i was also angry and upset. i would consider talking to your hr person. i didnt personally find that helpful and am now trying to find a way o finance it myself but you may have better luck with your employer. good luck!