Question:
I am in Florida. I called my insurer and they said my policy does not cover

bariatric surgery, period. Is that it or can I pursue them further and what is the first step? I have no major health issues from obesity except for diabetes.    — marshaely (posted on March 31, 2006)

March 31, 2006
Hi Marsha, My insurance policy (well - policies - we had two different coverages) didn't cover either. So I self-paid for my surgery. I went to Dr. Aniceto Baltasar in Alcoy, Spain. (See www.drbaltasar.com for Dr. Baltasar's web page.) I had my surgery July 2, 2002 and since then it has been nothing but amazing and wonderful in so many different ways! I've lost 210 lbs, diabetes, hypertension, a wheelchair, chf, sleep apnea - you name it! What a gift! If you'd like to see my pictures (from pre-op to now) you can go to www.bodybybaltasar.com and go to the photo gallery and look for my name. You'd be amazed at how affordable self-paying for surgery is - and it's tax deductible - it can make for a very nice tax year! Don't give up! The great news about the DS (the surgery I had with Dr. Baltasar) is that just the intestinal portion of the surgery is being done on non-MO folks to eliminate diabetes. It's so cool! So if you want your diabetes gone - look seriously into the BPD/DS! Blessings, dina
   — Dina McBride

March 31, 2006
'except ofr obesity and diabetes" those are two very big exceptions. Diabetes places you at greater risk for heart disease, stroke,kidney and eye disease,m hypertension, neuropathy and need I go on. Unfortunately obesity carries the same risks so you have just doubled them -I am not saying this to make you feel bad but to get busy and do the financial research to build a case to present to the insurance company - if they can see in black and white and $$$ that the surgery will save them money in the long run you might convince them. If your primary care is in support perhaps they or their PA/NP if they have one will help you with gathering the supporting documentation - another avenue is to go on the NCQA website and check out other insurers in your area and use them as examples to your insurance company and as a last resort the state insurance commissioner. You didn't mention if this insurance is private pay or through an employer or union. If the latter collect the supporting data on how your health conditions (present and future from potential complications) will cost the employer/union - if you can get them on you side they can also put pressure on the insurance company. There is no guarentee this will work but it definately won't hurt either and if nothing else should start educating those at your insurance company.
   — dabby

April 1, 2006
Marsha, also there are a lot of insurance companies that say they will not cover obesity related treatments, programs or surgeries - but that doesn't necessarially mean they will not cover treatment for morbid obesity. I would get clarification on that. Good luck.
   — kjoy

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