So I called the Insurance Co....
...and I was talking to my representive and she said they have not recieved any letter from the surgeon and my profile says they sent the letter out on 3-3-06 and she said the only way they will aprove the surgery is if I have diabetes or high blood pressure or something very serious that is proven to be caused by my weight. Well right now I SEEM to be healthy but I have all teh complication that a 24 year old extremly obesed person should have and Dr. Giovonni says I am borederline high cholesteral and I will 99% develope diabetes. So why not nip it in the butt right now why wait till I have all the complications. It makes noe sense to me so most likely even though I am a perfect canadate I wont get approved. Well all I can do is wait right. I go monday formy endoscopy and then the 25th to do a weigh in with Judy Carty. The good thing is I have a;ready lost 2 lbs but still chewing gum like theres no tomorrow. My tenative surgery date is May 25th so I hope the insurance Co. approves it. What makes me laugh is insurance Co. will pay for Drug and Alchol rehabs for 30 or more days but wont help some one to save there lives because of something they cant control. and I say this cause I know first hand my husband get into drinking nad drugs when he was young and then when he was like 20 or so he change dhis life around and went to college but a few years ago he relapsed and our insurance company not only paye dfor the detox but payed fro him to stay in a rehab fro 30 days. Dont get me wronge I am thankful and he is doing GREAT!! but he made the choice to get high and i didnt choose to be over weight. well I am done venting for the day I loove you all soo much for all the support and my thoughts and prays are woth you all always . Thank you April
I had borderline diebetes and high pressure when I had surgery and I was approved. I was 25 and weighed 350 lbs. My doc said that the insurance company would see that they had years of paying for meds and such or they could pay one big lump sum for me to get well. And they did. So keep hope alive, no point in worrying until you have a reason to. 
the only thing I can tell you for SURE is that 90% of the time, the ding-dong you get on the phone has NO idea what your insurance covers and why. You, thankfully, are not at their mercy, as THEY (customer service reps) don't make the decisions.
If your PCP and surgeon say 'medical necessity' and you meet the BMI standards, you're probably on the right path. If you could provide them with a co-morbidity, such as borderline diabetes, or GERD (acid reflux disease) joint pain, HBP, or such, it would be even better...
You have an insurance book- right? (if not- ORDER ONE NOW!) So read the part about surgery for obesity- what does it say? THAT is your best guideline, and potentially your best tool for fighting.
Hang in there. The insurance customer service reps play games- if your Dr's office sent the paperwork, tell them what your ins. co said and then have the Dr's office follow up and see what story they get.
Regarding your husband's situation- yes- I agree that insurance companies cover things at their whim or based on social pressure. For goodness sake- I can get (ok, well not ME personally) VIAGRA for a co-pay, but I can't get a weightloss drug paid for to save my life! Now, tell me- what' s more life threatening- Erectile Disfunction or Obesity????? Please- it's not even a question. But, still- Viagra is covered... SHEESH.
Insurance is a pain in the @#$ to deal with, but you'll get through it.
Best,
Lisa C
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