Question:
Sleep Apnea

I am sorry all, for phrasing the question the way I did. And I did query the wrong way too. Again. BCBS of Louisiana has a written exclusion for any kind of WLS regardless of medical necessity. And I am 5'4" 300 lbs. Diabetic, Hypertension, Orthopedic-Polio related, GERD, Hiatal Hernia, Depression, Chronic Fatique, Degenerative Disc in lower lumbar, and Sleep Apnea, since any type of treatment for the cause is out of the question. My question is has anyone ever had the surgery for any of the above mentioned illnesses other than weight loss? I was diagnosed with Sleep Apnea on Friday.    — Nancy B. (posted on August 27, 2000)

August 27, 2000
I am really disturbed by these insurance companies and the exclusions for WLS. You would think with all the money they pay out for your other health problems, they would rather just pay for your surgery one time. Over the years I'm sure your medical bills get pretty pricey. For the life of me I don't understand these attitudes about WLS. For some reason these idiotic (and probably thin) people assume we want to lose weight for cosmetic reasons only. I guess it doesn't occur to them that maybe we would like to have, you know, a LIFE! I'm sorry for what you're going through. I just had to vent a little. I get so dang ticked off at these insurance companies and employers for being so obtuse!
   — Keri A.

August 27, 2000
Another member at this site sent me some information. It is correspondence from Walter Lindstrom re: exclusions and ways to get around them. He specifically mentions this: "sometimes an ""exclusion""is not legally enforceable or simply does not apply to the case at hand. For instance, diabetics or persons with severe reflux or sleep apnea are often able to get surgery after an initial denial because the surgery is not for ""weight loss"" but rather, as primary treatment for comorbidities. There is caselaw we use which supports these and other aspects of fighting insurance denials." If I can be of anymore help email me. I was sent several pages of tips. I think this information most closely applies to your question. Best of Luck and Hugs.
   — JennyLynn A.