Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 cindy what kind of insurance do you have? Pre-Op LapRNY Surgery Date 10-21-03 Dr. K. Borhanian Rock Hill SC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Hi! I'm new to the group and I have a question. Have any of you had your insurance list " treatment of obesity such as gastric bypass surgery " specifically stated in the exclusions, but gotten it ok'd anyway? My PCP has suggested that I have surgery, and I've made the first appointment with the surgeon, but when my husband and I looked it up in our insurance benefit book, it is listed under things that the policy will not pay for. I figure I'm dead in the water, because we can't pay for it ourselves (10 kids...2 natural, 8 adopted special needs) but I thought I'd ask if anyone else has had this happen, then had it go through. There is no mention of it being excluded " unless dictated for medical necessity. " It says: This policy will not pay for......... I've about given up hope, and I'm heartsick, but I thought I'd ask anyway. Cindy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 Where do you live? Some states now have obesity laws that make it illegal for insurance companies to refuse treatment. It might be worth looking into...Good luck. TJ > Hi! I'm new to the group and I have a question. Have any of you had > your insurance list " treatment of obesity such as gastric bypass > surgery " specifically stated in the exclusions, but gotten it ok'd > anyway? My PCP has suggested that I have surgery, and I've made the > first appointment with the surgeon, but when my husband and I looked it > up in our insurance benefit book, it is listed under things that the > policy will not pay for. I figure I'm dead in the water, because we > can't pay for it ourselves (10 kids...2 natural, 8 adopted special > needs) but I thought I'd ask if anyone else has had this happen, then > had it go through. There is no mention of it being excluded " unless > dictated for medical necessity. " It says: This policy will not pay > for......... > I've about given up hope, and I'm heartsick, but I thought I'd ask anyway. > Cindy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 welcome cindy. " treatment for obesity " was an exclusion in my policy. however, i was not " obese " , i was " morbidly obese " , two entirely different scenarios. that loophole has been closed now, i suspect. do not give up hope, try, & keep the faith. your 10 kids are all worth it. lori h. 17 grateful months out Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 We have United Healthcare through my husband's job. summertodream1@... wrote: > cindy what kind of insurance do you have? > > > Pre-Op LapRNY > Surgery Date 10-21-03 > Dr. K. Borhanian > Rock Hill SC > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 I live in Florida. I've never heard of obesity laws...I'll have to look into that. Thanks! Cindy g8ct wrote: > Where do you live? Some states now have obesity laws that make it > illegal for insurance companies to refuse treatment. It might be > worth looking into...Good luck. TJ > > > > > Hi! I'm new to the group and I have a question. Have any of you > had > > your insurance list " treatment of obesity such as gastric bypass > > surgery " specifically stated in the exclusions, but gotten it > ok'd > > anyway? My PCP has suggested that I have surgery, and I've made > the > > first appointment with the surgeon, but when my husband and I > looked it > > up in our insurance benefit book, it is listed under things that > the > > policy will not pay for. I figure I'm dead in the water, because > we > > can't pay for it ourselves (10 kids...2 natural, 8 adopted special > > needs) but I thought I'd ask if anyone else has had this happen, > then > > had it go through. There is no mention of it being > excluded " unless > > dictated for medical necessity. " It says: This policy will not pay > > for......... > > I've about given up hope, and I'm heartsick, but I thought I'd ask > anyway. > > Cindy > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 8, 2003 Report Share Posted October 8, 2003 My ins is BC/BS(ppo) of AL and it claims for me to qualify for the WLS that it has to be medically neccassary. I was denied last year but I have a diff. Surgeon this time and hopefully I will get approved this time. In my policy it says that it is a once in a life time procedure that if I have any complications from the surgury and have to have surgury again b/c of the wls it will not cover it. I am still waiting on my surgeon to file my paper work with the ins. co. I had my pcp to fax a surgury release letter(had to have that before he would schedule) and went for my psych eval yesturday spent a sum...I am also hoping that all the tests and evals is not a waste of money but I had to have them done before he would do anything (what a bummer).....his staff told me that once he files that it would take at least 2 wks for me to hear from my Ins. The after the approval it would be anotther wait and then I would have to do more blood work the week before...... So keep me posted and I will do the same.....Good luck of AL Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.