Question:
They say ANYTHING to do with weight loss is not covered...
WLS or medication. Is there any way around that, or am I just out of luck? I am 33 and BMI 51. — Cindy M. (posted on August 28, 2004)
August 28, 2004
Find a part-time temporary job that covers, try appealing, mortgage loans,
etc. It's hard, but I'm going with the notion of trusting what is meant to
be, will be...
— Linda J.
August 29, 2004
If they are saying there is an exclusion in the policy for the surgery,
there isn't much you can do. You can't legally force insurance to pay for
something they never covered in the first place. If you live in one of the
few states that mandates the insurance coverage then that is another thing
entirely but it is doubtful that you do since very few states have this
law. Wish this was more positive but more and more insurances seem to be
excluding the surgery. The only other possibility is to talk to your Human
Resources Manager at your work place and see if there is anything they can
do to get you approved. If it isn't covered because of the policy they have
taken out many times they can ask the insurance to approve you as a one
time exception. It is worth a try.
— Greg D.
August 29, 2004
My mother is going through the same thing right now. Her insurance doesn't
cover it and there's nothing you can do. My aunt is an insurance broker
and found some insurance for $100/month that covers the surgery, I believe
she said it pays 30% of doctors fees and 80% of hospital fees. It's all
based on percentiges but some is better than nothing and it even covers
plastic surgery. She said it's a new program and is sending her a booklet
on it now. It's something I may look into myself for the plastic surgery.
So my mother figures she will refinance her house if she has to. If this
program turns out to be as good as it sounds I will post the info on here.
Hang in there.
— boonikki29
August 29, 2004
First, have you filed a appeal with your insurance company? I would also
see how your doctor worded the referal to your insurance company. Have you
written a letter explaining all of the diets you have been on and how the
weight has effected your health?
— Linda R.
August 29, 2004
You can fight your insurance company on this issue!
There is a lawyer in California--Walter Lindstrom who will fight your
insurance company and get you approved.
I heard that he does not charge alot for this.
Good luck in your journey.
— sassychick247
August 30, 2004
Cindy,
You could fight - if you have the resources and the time. I didn't - my
BMI was 64 and I was dying. An attorney told me to save my pennies and
time and self-pay. So I did.
I had my surgery in Spain with Dr. Aniceto Baltasar
(www.bodybybaltasar.com) and I am SO thankful that my insurance DIDN'T pay
- or I would have not been led down this incredible, exciting, wonderful
path!
Let me know if I can answer any questions.
Blessings,
dina
— Dina McBride
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