Question:
Does anyone know what I should do...............

I was told that my insurance(PPOM)has an exclusion from having WLS even if it is medically needed.But I do not find anything about obesity or wls in my policy.What are the steps I should take to finding this information out?    — Laurie W. (posted on February 17, 2002)

February 17, 2002
Laurie, I had PPOM through Meijers and was covered. I know of at least 3 other people that they had it covered too. Who do you have PPOM through?
   — Phiddy B.

February 17, 2002
Hi there. I do insurance billing for a hospital, and I know that PPOM just reprices. Your actual insurance company that should be on your insurance card somewhere is the payor. Maybe PPOM has that exclusion, but they have to go by what your ins company covers. Hope all goes well!!
   — Sonya P.

February 17, 2002
hi, i was approved in less than 2 weeks for surgery, i have bcbs teamsters ppom. good luck
   — rebecca N.

February 17, 2002
I have PPOM through american medical security which is offered through my husbands work.
   — Laurie W.

February 17, 2002
I had my surgery done at Bariatric Treatment Center in Wylie, TX. I don't know who you are planning on using, but BTC sure took a load off my mind in the area of insurance coverage. After paying $80 for my initial consultation, BTC took care of ALL my insurance needs, I never even had to speak to anyone at my insurance company's office. BTC has people that specialize in working with insurance, I think they even have a lawyer in their employ. Our insurance company stinks and I didn't think they would cover WLS (and I am at a loss when reading our insurance policy), but I was approved after the first letter from BTC. Good Luck!
   — DonnaCarol

February 17, 2002
My surgeon's office took care of all of the insurance needs, I never had to do a thing in that regard. I was approved in 4 days, without any major comorbidities. I believe most surgeon's offices operate in this manner. Ask their office staff. They are generally good at knowing what insurance companies want and how to present information to give you the best possible chance of approval. Good luck!
   — Donna L.

February 17, 2002
Remember, even though ins cos are required BY LAW in many states to cover WLS, not all employers opt. to purchase this coverage...this exclusion could be due to your employer. I do hope it works out for you, but it may be an employer exclusion, which could be tough to fight. Good luck!
   — rebeccamayhew

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