can someone help!!!!!!!!!!

hi, I am new to this ,right now I am doing the research with my ins company,they said they wouldnt cover the surgery, I have bluecross/bluesheild-hmo-, as some may know this is very hard, they say no what do I do,my pcp&other doctors say yes some of my problems mostly with my stomach , I take prevcaid 2 times a day ,zelnorm,I am having trouble with my liver,and pancrea,swelling,when I hurt my back about 8 months or so,my doctors did injections in my back-but no telling me about thee weigh gain I have gained about 150 with the steorids, my B>M>I> is abot 46 1/2, I really,really want this surgery can you give some advice? Thank you for your time in advance.............................. Gloria

If your insurance won't cover the surgery then you can go self pay. You can get a line of credit on your house, borrow from a 401K, and some doctors offices have finance companies that will work with you. You just have to get creative to obtain the money. You might want to also look into the Lap Band. It costs considerably less than RNY.

Keep appealing!!! My husband and I were denied 3 times each from BCBS of GA PPO and we kept finding out why they denied and fought it. We were finally approved a year after our first request. I work at a doctor's office and am use to insurance companies either losing the info, making typo mistakes and all sorts of other tactics to delay the requests. I think they think that people will give up. Just keep fighting them!!! Best wishes. Georgina

Most insurance companies stopped including WLS in their coverage about a year and half ago. Your company that you have insurance with will have to purchase a rider that includes WLS so you may want to talk to the HR person at your company or your husbands company which ever the case may be to see if they would be willing to pay for it. You can not really appeal this with the insurance company because they aren't turning you down because you don't meet the requirments but because your employer has chosen not to pay for it under your benifits. Best of luck to you. Take care.

Be sure to get a copy of the exclusion in writing, they have to send it to you if you request it. Also make sure you ask them if weight loss surgery is covered for morbid obesity if found "medically necessary". Often times the insurance company will tell you no if you don't include "medically necessary" in your request. Hope this helps!

Did you give them the CPT codes? If not call you PCP and obtain those and then giv eit another try. Also you might find that if you go online and can register on your insurers web site that you can find the info your self. I am w/ Humana PPO and I actually have a RN assigned to me by Humana. My nurse has been a great deal of help. don't give up! You can appeal it. You can talk to your HR dept. You can write the GA ins commisioner. I know it is hard. All of us here on OH have traveled th same roads. My prayers go out to you and yours.