Insurance problems - WLS not covered

Just wondering how many others have/had this problem? If you did get your insurance to cover it, how'd you go about doing so? My ins. won't even cover visits to DISCUSS any type of weightloss.  I don't believe I have enough co-morbidities/disabilities to qualify for Medicare which would then cover the surgery. 

First off, can you copy the exact woring of your insurance policy here? Most insurance policies don't cover "the treatment of obesity", but DO cover treatment for "morbid obesity"---medically speaking, two different things.

Secondly, talk to your HR departemtn. In most cases, it's the employer who decides whether or not to cover WLS. Some employers elect to not cover because it makes the premiums higher if it's included care. Depending on how your insurance is set up, it may be possible for your HR department to GET you personally covered.

Third---what disabilities and co-morbs DO you have? What's your BMI? Getting Medicare before you reach the age of retirement requires you to be declared disabled, and even then there's a waiting period before Medicare covers you. It used to be two years, but that may have changed.

And---there's always the self-pay option. This can be quite affordable, especially if you're willing to go outside the US for surgery. Last I knew, you could go to Brazil, get a DS with a world-class surgeon, and spend two weeks recovering in a very nice hospice-type enviroment with a group of fellow English-speakers, all for about $16K.

Msbatt is right. Many WLS'ers opt to go out of the country for WLS when it's not covered by their insurance. There are some excellent surgeons in other countries. Just don't go with the LOWEST price. There is generally a reason for that!

Having comorbidities doesn't qualify you for Medicare.  You can only get Medicare if you are 65 years old OR if Social Security has declared you disabled and you qualify for SSDI.  After you have received SSDI for two years, you will get Medicare.  If you are disabled and cannot work, then go apply for SSDI.  Otherwise, you'll have to wait until you're 65 for Medicare.

I would check the wording on the policy.  The first time I tried to get my surgery, the doctor said that if it says "not covered" you can have the doctor argue that it is medically necessary and possibly win.  If they say WLS is "excluded" then they won't pay for it no matter what.  My hubby's insurance had it excluded completely, so I had to use my insurance through where I worked.

Best of luck!