AAArrrrgggggghhhhhh . . . Insurance

Okay, I DO have a suggestion for a separate board. We have so many people fighting the insurance companies on one level or another that it just might be worth it to have a board that deals specifically with that. It's a bit difficult to comb through all of the posts to find specific insurance discussions . . . just a thought. In the meantime, I have a question. I have confirmed that no version of the insurance offered through my employer covers any form of WLS. Blue Choice had chosen at one point to include it of their own accord, but have chosen to discontinue that inclusion effective 1/1/05. My question is this, is there anyway that I can get any portion of the costs associated with the surgery covered? I mean, is there any way that the pre-op testing, etc. can be submitted to where it is covered? I need to start seeing now if there's any way I can come up with the funds to cover the surgery. I'm open to going to Brazil, etc., but I really don't want to do so, meaning I'd have to have the surgery done open, unless it's absolutely, positively the only way. In short, all you imaginative and resourceful people out there, is there any way to reduce the amount that I'll have to pay out of pocket . . . any way at all . . . anything . . . ??

Talk to your PCP depending on your co-morbidities there may be some legitimate medical reasons other than WLS to have diagnostic testing done to determine the scope and extent of your health issues. Nothing is to say that once these tests are completed that the results could not be forwarded by you to a bariatric surgeon.

If you qualify for wls, then it is justified that you be screened for you cronic snoring (apnea sleep study), diabetes ctc and a1c blood test. , coronary status so you can exercise. pysc because you feel down all the time from your wieght, or posibly diabetes, these are standard of care items, that may leed you to consider wls.

I'm embroiled in my own insurance nightmare too. Try this Yahoo! Group... it's very active and helpful. http://health.groups.yahoo.com/group/DS-Insurance_Authorization_Problems/ Annie

Hi Annie, Just wanted to thank you for your input on the panel last night. You were great! Also wanted to tell you that you are even prettier in person than your photo here. Hoping to join you on the losing side soon.. Until then .. Have a great week or 2 as I am outta' here. Wyomong here I come

Oh my, I'm blushing Thanks so much, hon. Yeah, it was a cool meeting, and I was glad to help Jackie out when apparently her 6-monther didn't show up. I have a checkup on Thursday and she's gonna KILL me for my frequent weighing (and guarded advocacy thereof) hehehe. Have a great trip, and come say Hi at the next meeting! Annie P.S. So sorry for the hijack

Annie, Thank you for the link. I have been looking for something like this since I've had my own problems with BCBS. I'm hoping I'll find the help I need on there. Thanks again Elaine

Thank you, thank you . . . thank you.

I was self-pay due to an exclusion but ALL of my pre-op testing AND my post-op lab work was covered--just ask the consultants, labs, etc., to use a code other than pre-op consult. I had them use DM2 and morbid obesity for my pre-op diagnosis codes. Post-op labs are coded with the diagnosis of "malabsorption NOS"

Thanks so much for the tip. It's a shame to have to find ways to beat the system that's supposed to work FOR you.