Newbie!! About me

So I'm new here I have been lots of research found this site and thought I would join. I currently am morbidly obese. Below are my stats 

bmi of 45

Age 28 

weight around 320 

5' 10" 

diabetes, Hypertension, high cholesterol,  Gout 

i have been doing a lot of research about the forms of bypass what each means and of course the life after gastric bypass. When I was diagnosed with diabetes I was eating constantly with a high weight around 360. I have since lost those few extra pounds but as most of the time my hunger pains get the best of me. I do good for a while and don't usually miss the sweets or pop much but once I fall off the wagon I go completely.  I have been horrible lately and I'm have been within the last week to try to be better.  My main issue is I eat what is considered a large but healthy meal but my stomach tells in about 2 hours later that's its hungry again  and if I wanted I could eat another complete meal.  Excercise seems to make my knees hurt no matter how light it is. 

 

I am am past the point of no return. Im sick of being tired and unhappy with my weight but diet alone does not help my hunger issues. 

 

I have united healthcare insurance I'm planning on contacting them this following week but it says clearly on the prior authorization request and list obesity- morbid obesity but later down documents it's list under Exclusions and Limitations  surgical and non surgical treatment of obesity 

 

my question is what the difference it says it requires prior Authorization for obesity- morbid obesity but then says surgical and non treatment for obesity is excluded 

 

does this mean you have to be morbidly obese before they will pay ( I am already) or am I'm a miss understanding the documents I have a feeling the insurance company is going to just lie that why I'm asking 

 

thanks for your time 

Sounds to me like your insurance plan doesn't cover obesity surgery. I sure hope I'm wrong. 

I. Believe that means that this particular insurance company covers bariatric surgery for qualifying morbidly obese patients, BUT, your employer did not buy the coverage for their employees and that is why it is showing under the exclusions clause. 

If it is excluded,they will not pay for any WLS period,which will leave you self paying. 

GL

It just don't make sense. I am living in indiana I have read about a law that Indiana has covering this surgery. My employer is also in Indiana and my statement of coverage document says it's fully insured??? it mentioned something about the law about fully insured vs self insured either way I plan on contacting them in the next week to check it out 

I can't help you with your insurance question, but since you mention having diabetes, high cholesterol, and gout, I'm going to urge you to also research a form of WLS called the Duodenal Switch. The DS has the very best long-term, maintained weight-0loss stats, AND the best stats for resolving or preventing diabetes and high cholesterol. It will even allow you to still take NSAIDs for your gout.