Question:
I am so frustrated......I guess I'm just venting......
I have spent 8 months researching every night for WLS...prepared my family, prepared my husband. etc, etc. etc....I have ins and my husb has ins..EXCLUSIONS...so I saved up the money and just a couple of weeks ago set my date for Jan 30th....then....last week my husb calls me at work and says to look into other med Ins for them because he wants to change his company's...well I got all excited and started looking into it...I live in Washington State and we live by the border of Canada...all the good polices are in the Seattle area...no doctors up here so my husb's company's employees would only be covered 70% etc etc etc....I can not get my WLS covered here and It's so frustrating that EVERYONE but me gets their WLS covered...oh well, sorry just venting....I'm back to SELF PAY. Thanx — Debora H. (posted on October 24, 2000)
October 24, 2000
Don't give up!! There are ways to get around exclusions. I am pre-op
myself and pre-approval, too, for that matter. I'm hoping to get approved,
but the insurance companies are not consistent in their rulings, so nothing
is ever certain. I have seen many things posted about fighting exclusions
and I know there is an Obesity Law advocate named Walter (?) that maybe
someone else can post about. I have heard that he charges about $400 to
send a letter to your insurance company, but it's about a 30 page letter.
His website is at: www.obesitylaw.com I would definitely check into it
before spending all that money on self-pay. Either way you go, I wish you
the best of luck!!
— Laura B.
October 24, 2000
Hang in there!! The lawyer's last name is Lindstrom and I hear he is
really good, I don't know that personally but he has a good reputation on
this site. I guess I wasn't clear as to whether or not you have ttried and
been turned down or that it simply states in the policy the exclusion. If
you tried and were turned down I would appeal the decision, if your just
looking and that's what it says in the policy, make sure it doesn't state
unless medical necessity is found. My insurance company put that clause in
there policy and couldn't turn me down when medical necessity was proven.
Good luck to you, if you have to pay for it yourself just remember that
investing in your health and well being is worth every cent, you will thank
yourself when you begin to reap the rewards of the surgery. Open RNY
08/21/00 50 pounds gone forever!!!
— christine L.
October 24, 2000
Don't give up you are not alone in this battle. Take a look at my profile
and if you have any questions or just need to talk just e-mail me. There
are times that I feel like I am the only one not able to get WLS to because
of the insurance co.
— richter454
October 24, 2000
I was self pay, and I would have paid double. The price of a car is nothing
for a whole new life. However, If I had gone to support groups earlier, I
would have gotten all of the information I needed to get my insurance to
pay. Research research research. Good Luck to you.
— Cara S.
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