Good morning, saints, I have my first dr. appointment scheduled with Dr. Rutledge on 9/27. (Well, first appointment this go-round with trying to get surgery.) I'm excited! I also found out that my employer has put an exclusion in place for the WLS. But after speaking with my HR gals and explaining that my doctors have recommended this surgery for medical reasons, they said I could appeal it and they would help out in any way they could. I remain hopeful. I work for a great company - they reimburse all tuition expenses, adoption expenses, expenses related to charity work you perform. They even offer 100% free college classes on-site towards your A.S. or B.S. degree. 100% free - no strings attached. I find it hard to believe that they've excluded WLS as we have several obese folks working within this facility. But with that said and judging on how good they treat their employees, I also hope that I can appeal to their sense of reason (and compassion) and get this surgery approved. I know in speaking with a few folks and also reading up on approvals, I've seen a handful of people approved when it should have been denied, either because they didn't meet criteria or clerical errors (i.e., the surgery is not covered but was somehow approved). I'd even settle for someone coming into work, hungover, and approving me, first shot. Hey, I'll take an approval however I can get it. I wish everyone the best in your WL journey, wherever you may be on your path now.

Bela, make sure when your physician writes his letter to the insurance company he stresses that this is a life saving procedure and NOT cosmetic. He can then list the different co-morbidities that you have. This is a long shot but good luck. Melody

Hi Melody, No worries about the response time! I can see that this board isn't quite as active as some of the other boards... and I sometimes am too tired to get on here at night. I have sleep apnea, high blood pressure, borderline high cholesterol, insulin-resistance and now pre-diabetes, Polycystic Ovarian Syndrome, Irritable Bowel Syndrome, and the beginnings of arthritis. I know that 2 of my doctors will definitely write me a letter of recommendation... I just hope it can be convincing enough. At this point, my employer still has not submitted my information to my insurance company. Our coverage is retroactive, but I would have to pay first and be reimbursed later. I don't have that kind of money at the moment, so I have to wait. Along with them not having my information, I also can't ask the insurance company about the exclusion and if WLS is allowed with comorbidities and in need of medical necessity. I pray it all goes well, but my gut keeps telling me that I'll be denied. Wow, that was wonderful of your surgeon to not pursue the costs with you! Most docs would have just turned around and came after the payment, regardless of it being their error or not. Wonderful!

Sorry Bela, I haven't checked the board for several days now. I know that most insurance companies have exclusions and people really fight hard to overcome that. People that have co-morbidities like sleep apnea, high blood pressure, diabetes, things like that have their doctor write a letter to the insurance company for them stating that this WLS is NOT cosmetic but is a life saving feature for them. With enough push sometimes the insurance companies will cover it. Good luck. This is a long hard road. Sorry I wasn't any more help. BTW - My surgeon told me that he would do my surgery and then in the end my insurance denied paying for it so my surgeon ate the cost. Good luck. Melody

Hi Ruth. I just stumbled upon your story and was so moved. I was recently diagnosed with PTC and I no longer have insurance and im scared and in pain. I also live in Utah. In Orem. I was hoping maybe we could chat one on one via email. My email is [email protected]. I look forward to hearing from you.