Help

Hello all. My name is Amanda. I am 24 and I live in texas. I currently weight 249 and have a bmi of 44. My currently insurance says they do not pay for VSG or any other bariatric surgeries. So I am wondering if anyone knows of any solutions. Thank you kindly

You can self-pay, here in the US or in Mexico.

I find it so odd that an insurance company won't pay for surgerical intervention (a one-time payment) versus potentially paying out thousands in management of obesity-related health conditions.

 I was a self pay....I tried lots of banks and medical loan places and credit unions. I am in Utah so I don't know if you have America first. But we got a great rate from them. We have good credit. It will be paid off in 4 years and only approx. $400 a month.   You have to call around.

Hi Amanda! Have you asked your insurance company WHY and if you can appeal their decision? There are many on here who have fought for their surgeries and won. Do you have a primary care doc that is supportive of you having the surgery? You could always ask for a letter from him/her that says this is necessary. Do you have documented co-morbidities? If so, that is also something to discuss with the insurance company. Let's say you have high blood pressure and high cholesterol. Ask the insurance company rep what their offered solutions are for those problems. Then ask if they would cover WLS to correct these problems and if not, WHY NOT? Good luck to you.
Jeni

 i have sleep apena.

I had my surgery date all scheduled for the band back in 09, when they called and said that the company I work for had an exclusion on the policy for any kind of bariatric surgery.  I fought it.  It too****il January of 12 to get it appealed but now anyone who works here is able to get it.  The health benefits outweigh anything cosmetic.  I'm now awaiting my approval to get the sleeve (thank God I didn't get the band!).

I too have severe obstructive sleep apnea.

Don't give up.  Talk to your insurance administrator, owner of the company, whoever you need to talk to.

Good luck!

Ok, so the real question here is, does the insurance company not cover it, or does your specific plan not cover bariatric surgery?

The answer can make a lot of difference.

If the insurance company doesn't offer the coverage, there is probably not much you can do. However, if your specific plan doesn't cover it, you can likely appeal that decision, and with the help of your doctor, may be able to get it overturned.

 i have aetna. and my plan doesnt cover it. i dont know about if the company does or does not

 Ugh, I am sorry.  I had them when I lived in Seattle, and they had a nasty habit of kicking back every. single. claim.  I had to fight for them to pay my annuals, my birth control (which was expressly covered), etc.  However, I worked with my doctor and the folks in HR to get a (non-wls) procedure covered.  
They kick because they know a pecentage of clients won't fight it and will just pay.  Kick back!