What is up with this?

My BMI is 49.5 I am 5'3 280 right now i have no major health problems but was told if i don't do something now i will in about 5 to 10 years. So who knows! Billie Jean

Billie, Sounds like you are getting alot of confusing information regarding your insurance coverage. Most insurance companies have a WLS exclusion, mine did too... They would not cover it unless it was medically necessary. You will need a Letter of Medical Necessity, documentation of weight loss attempts and a BMI over 35 and any other supporting documentation... like co-morbidities. Have you decided on a surgeon yet? That would be the first step. Let them tell you what you need... they will do a pre-authorization with your insurance company and let you know if surgery is even possible. No need to stress yourself about it now... leave the administrative stuff the to doctor's office. Attend seminars, research the doctors... then you will get more info about insurance.

I was told before i even go to the WLS doctor i need to know if my ins. covers it. If i don't i will just waste the doctors time. This is what my policy says "Surgical treatment and non-surgical treatment of obesity ( including Morbid obesity )" And one of the ladies i talked to said that i could do the who appeals thing but i would be wasting my time and my employers money which in turn will cause us to have to pay more for our ins. with less coverage. Like i said before i just don't know where to start. I am a single mom who doesn't get any child support and i don't have the extra to be going to the doctor when i have to pay out of pocket. If it has anything to do with weight loss my ins won't cover. What to do what to do! Billie Jean

Billy Jean Have you checked out the Tucson group, TUSWLS at yahoogroups???? I'm sure they will be able to help you with some of your Tucson related questions and more. Between that group and OH I have learned a lot and was able to get approved and have the surgery in Sept.

I went through Dr. Aguirre in Ensenda, Baja California Mexico. The cost was 10900. whi*****luded the hospital Dr. and a couple of nights in the apartment. They are not technologically up to date. kind of like being in a time warp. They actually admit if they made a mistake. ( no worries of lawsuit). If they do make a mistake he will fix it free. ( just not the hospital stay cause it is not his) when out of the hospital you can hire a nurse for the day for about 50.00.

I know Dr Schwartz charges about $18500 for cash patients and gets you in real fast