Question:
Cost of surgery vs. Cost of future care

Can anyone send me some statistics on the cost of surgery vs. the cost of future medical treatment that I can use in my persuasive argument with the insurance company? Thanks.    — K T. (posted on February 22, 2001)

February 21, 2001
Good Morning....good question! In my case my company is self-insured & refused to pay when I first asked for WLS in early '99. Early in 2000 I developed obstructive sleep apnea....then heart: atrial fibrillation....then in June I had a mild stroke. I also re-requested the surgery again & MY COMPANY TOLD ME NO!!!!!!! I was both stunned, hurt & VERY PISSED OFF, but wanted to save my life. I borrowed the money from my Credit Union & found the lowest possible cost in the area (I live in Dallas & had the surgery in San Antonio...$8-$10thousand less there because of a special arrangement w/Methodist Hospital. Well....all in all my company paid out in excess of $38,000 for my total health cost in 2000! Had I had the WLS surgery in early 1999 their costs would have only been between $17,500 - $21,500 here in Dallas. Now in 2001 I have been in ICU care twice...once for atrial fibrillation (heart) & most recently for gastro-intestinal bleeding in ICU care.....probably cost a minimum of $20,000 PLUS for both times...all because they refused to pay for the surgery in '99.....so we both became LOSERS...the company w/Cash and me with poorer health, but now w/ an 82 pound loss in only 4 months....my motto: "What goes round comes round!" Good Luck, Thom
   — Thom C.

February 22, 2001
This is something I'd really like to know too. Anyone know of websites or articles about this? Maybe we could do our own anecdotal research, better than nothing. This seems to be the big thing the ins. companies don't get, that this is preventative surgery! Ok, I haven't even been denied yet and I'm already getting huffy. :)
   — kcanges

February 22, 2001
This is a great question and one that I think the insurance companies need to consider before they just say "NO" to WLS. I have had over $100,000 in medical bills this past year that are all weight related and my insurance company has paid them without even batting an eyelash. All of these could have been prevented with WLS. But for some reason the insurance companies look at WLS as a vanity fix. I feel that if a qualified Baratic Surgeon reccomends the surgery, then the insurance company should not even have to get into the act. It is just good financial sense. Debbie Viren
   — Debbie V.

March 30, 2001
HI, Go to www.clos.net and there is a sample appeal, which lists alot of helpful information about what it costs the insurance and the employers for obesity. Its very long but some really good information is there. Hope this helps !!
   — LAURIE W.

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