Devastated!

My insurance company will not pay for the surgery They said I do not meet the medical criteria to have wls, apparently I am to healthy I do not have any issues related to obesity, my bmi is crazy high but  apparently thats not enough. I am now looking into different insurance coverages. I didn't think I would be so upset if I heard no, boy was I wrong!

How high is "crazy high"?  Typically, a bmi above 40 qualifies you for surgery without any other issues.  If you're over 40, get a copy of your insurance policy and find the provision where it describes what requirements they have.  Insurance decisions can be wrong, and can be appealed.

My bmi is 52. What is so frustrating too is, there is not a break down of of the medical criteria in the policy. I'm not giving up!

There HAS to be something written that identifies the specific criteria for medical necessity!  Insist that the insurance company (or, if the insurance is through an employer, your HR dept) provide you with a copy of it.

Lora

I agree. I am helping a friend appeal and we were able to get the very specific criteria in writing from her insurance company and the appeal letter addresses each point. 

Well that sucks!  I found a forum about insurance issues.  Post there and see if anyone has some suggestions on how to fight you'er insurance.

Insurance, Cash Pay and Financing

Appeal!

We did a search for appeal letters and here are some examples.  Good luck!

http://www.obesityhelp.com/search/action,search_oh/?q=appeal +letter&cx=000946886326336472648%3Ae-vpeg4uyxw&cof=FORID%3A9

definitely appeal!, your insurance is being cheap, however if and when you do change ins, check if you have to stay with them for a certain amount of time, they may not want to pay for wls right away, even though they'll  cover it.

Check with your WLS surgeon. I've found that the gals in my office are wizards at  getting insurance coverage.