Any teachers on the board?

I have United Healthcare PPO which has a written exclusion policy. You guys, I really need this surgery. I'm 35 now and I've been on various diets since I was 10 and have dieted my way up to 311 lbs. If anyone has any advice on what to do when your insurance has a written exclusion policy, please let me know. I need help badly. Is it feasible to purchase another health insurance policy and pay SKY HIGH premiums for a while just to get approved for the surgery? I'm not married, so using my husband's insurance is not an option. Any words of advice would be appreciated.

Janice, Just letting you know...I have an individual policy with BC/BS...and my surgery was not covered at all. Yes, I paid the cash pay price for my surgery, but it was well worth it. If I had to do it all over again...I would in a heart beat. I have heard of some people that have taken a second mortgage on their home to get the money to pay for the surgery. Remember the cost of the surgery is close to the price of a car, but this surgery will last a lifetime, but a car wont!!! Norma

WOW Norma! Thanks so much for responding. You've given me more to think about. The price of a car, huh? You really put it in perspective for me. Thanks for your words.

Hi Janice, sorry you are having problems with your insurance. I have UHC PPO as well, so I know where you're coming from. I thought I would offer some thoughts from my experience, for what they're worth: *First, sometimes you can squeeze in WLS, even with a written excusion, if you can tie it to a related, medically necessary surgery. For instance I had RNY in 2001, and my insurance at the time covered it even with a written excusion, because I had a massive ventral hernia that needed repair. My doctor convinced the insurance company that WLS was also necessary, and could be done simultaneously, to prevent the hernia from recurring since I had had multiple hernia repairs previously. I know others who have had hiatel hernia/WLS, endoscopic esophagal repair/WLS, etc. * Next, WLS doctors often are associated with private finance companies that will finance your WLS. My current doctor, Peter Henderson, of Georgia Coast Surgical in Brunswick, is associated with two private lenders that finance WLS. I would suggest that you ask your surgeon about any private financing he/she is affiliated with. After all, it is in your surgeon's best interest to help you find financing for your surgery! * Finally, never, ever give up. If you really need and want WLS, it is already on its way. It's just that our needs and desires don't always arrive on our schedules. Life, fate, whatever is funny that way. But there is a path that will lead you to your WLS goal. And by your taking control of your health, instead of letting time and cir****tance control you, you have already started your journey down that bath. Congratulations for proving that your are already a champion of life on your own terms through your insight and committment. You can do it! I hope this helps in some small way. Hang in there, and best wishes for you in all your endeavors. Steven

Hi Janice, I'm a teacher in Ga. I'm in the boat with you. My husband also works for the Liberty Co. BOE so we're on the same policy. No help there. I'm also seeing Dr. Peter Henderson in Brunswick as Steven below is. He offers a special rate for teachers and as Steven said, he does provide financing alternatives. The hospital there will also finance part of the surgery. I'm planning to have Lapband in Oct. and will be self-paying. Like you...I've dieted myself up to 285 lbs. and it's just time to do something. 2 teachers at my school have had it done in the past 2 years and both self-payed. One of them has lost over 90 pounds and looks fab. I can't wait to get started! Good luc****ep in touch. If you'd like to e-mail me please do so. [email protected] Lyn

Janice, if you purchase another policy, there will probably be a waiting period of at least a year before you can apply for surgery. I also noticed in my doctor's office a pamplet for financing. i took one of them, but I can't find it now. Maybe do a google search? You can also check at your bank. If I'm not mistaken, the interest rate they charge for medical expenses are lower than what they charge for other things. Best of Luck! Becky

Thank you guys so much for your replies! I will look into self pay. It's nice to know that I'm not alone.

Janice, Is it possible with open season coming up to change companies?