Frustration

Currently I am meeting opposition from my employer. My insurance company covers weight loss surgery and treatment. However, when the hospital I work for set up our plan they decided to exclude weight loss treatment of any kind with out regard for medical necessity.When I hired on it was included in our plan and now it has been excluded basically because an employee had some complications. My doctor told me that some one else at the hospital has been approved, but due to HIPPA she can't tell me who. I spoke with my surgeon's office and they want to compose a letter for me to sign and foreward on to the benefits coordinator and to be honest I also want to sent it on to the hospital CEO and VP of HR, who seems to be the person making these decissions. I am going to be banging my head against and brick wall, and it really torques me off. ARRRRRGH!

Hey Linda, How unfair is that? I tell ya, I know you were fit to kill huh? And they need to wake up and smell the coffee. There are people out there that really need this surgery. So just try to stay calm and work with your doctor and dont give up. Just think, the insurance companies would love that........ Hugs Marge

Hi Linda, This is EXACTLY the situation I was caught up in for about a year, except it was BCBS saying my (ex)employer elected the exclusion and my (ex)employer saying it was BCBS. They batted me back and forth like a tennis ball for about 11 months, and I never got either to budge and make the coverage. Finally I changed insurance coverage and got surgery two months later. I wish you every kind of luck on this and hope you're successful. It's a contradiction all the way around ... employers want to keep claims $ down so their premiums won't increase, and yet they won't cover a surgery that will, in the long run, reduce future health issues (and claims) for a post-op, and insurance companies are denying coverage so they can keep more of premium $ and simply make more of a profit. Hang in and keep fighting. I read a profile on the main board (I wish I remembered the name) of a lawyer who won out against stuff like this to have surgery. Post your post there, and maybe she'll answer you. (fingers crossed) Myra G

Linda, I'm sorry to hear you are having to fight this battle. But, don't give up! It will be so worth it. The hospital I work at used to do WLS, then a patient died, so it was discontinued (it was the daughter of a surgeon here). But, luckily for me the University decided about 2 years ago to cover the surgery, but, I had to have it at a different hospital. There is no doubt this is a risky surgery...but so is being super morbidly obese! Hang in there! Lori 384/242/168

I feel like they are saying to me ---you are fat, you don't deserve treatment, now go away and die.

I am going to be right beside you soon. My inaurance has an exclusion, too, with no regard for medical necessity or strict guideline. High BMI or weight would be an excellent way to determine real need. Do I feel discriminated against? If anyone has had success we would love the information.

I sat down and wrote a letter to the insurance comminnioner of my state to let her know how I felt about it too. Thought about writting to my senator, representative and governor too.