Doctors supporting WLS taking new patients??
I was looking for a generic doctor that supported weight loss surgery and would help me get my ducks in a row so I could get approval from an insurance company. I had an appt yesterday with a doctor, she seems to be very supportive. My problem is that other than my weight, I am very healthy which means getting approval will be harder than I thought. Help!! I really want the surgery. Any suggestions??
Hi Juli,
I am from Northern Idaho and am just starting to look into this seriously. You sound a lot like me. My BMI is 37.44, less than the 40 and I am not being medicated for any health problems yet. My blood pressure has been high and my blood sugars have been high. My cholestorol is high and I'm suppose to be on lipitore, but wanted to try diet and exercise first.
Sorry I don't have an answer to your question, but I would like to have someone to talk to about the steps in doing this.
Thanks...Sharlene
Thanks for your reply, it is very frustrating because the company I work for has an exclusion that they won't cover WLS. My company is being purchased and I am hoping the new company won't have an exclusion. I have researched every method out there from buying a health insurance policy, which won't work because like I said earlier, I am very healthy other than my weight. They do have companies out there that will loan the money but that would be my last option, its like another car payment. If you find out any other options, please let me know. I want the surgery so bad.
Thanks Juli
BC of Idaho has an individual policy that will cover the WLS surgery. I have that now and was approved within five days. My insurance premium did go up a little because of my weight but I didnt have hardly any other problems to speak of. My premium is about $221 a month which I can handle and yes its like another car payment but its worth it. They will how ever not cover any plastic surgery afterwards so that is a route you have to find on your own just like me. You can call Intermountain Agency in Boise and they will set you up with an individual policy. They are a broker for BC of Idaho. Great people too. Talk to Barbara Stott. Good luck.
Thanks for the info, I will check it out. I did call a insurance agent and he could write a policy for me but when I talked with BC/BS they said I had to have one of the following diseases, High blood pressure, high cholesterol, sleep apnea or diabetes. Do you have any of those? I do not, I do have a problem with my knee and have been going to physical therapy and my therapist wrote me a letter stating that weight loss would help my knee pain. THat is about all I have to go with. Do you think insurance would still cover the surgery? I am willing to spend the money for the insurance, but if they still wouldn't cover it it would not be worth it. I have to cancel the inusrance I have with my employer to get another insurance, my employer has an exclusion in there policy to not cover WLS. Let me know what you think. THanks. Juli
I do not have high blood pressure, diabetes or any other problems. I do have a knee problem and back problems like you and that is what I stated. Keep that letter that your physical therapist wrote. That will help with your letter the doctors office will write you. Talk to Intermountain Agency off Overland Rd. Talk to Barbara Stott and tell her you want the BC of Idaho plan. You want the PPO plan. You can also go to their website by doing a search for Blue Cross of Idaho and look at their different plans available. This does not exclude WLS surgery unless their is a medical neccessity. The doctors office will write up a letter for you stating it is a medical necc. They will also include that letter from your physical therapist. You will want to start the process with the agency first to obtain a new individual policy. Once the policy has been approved you have 30 days to cancel your insurance from your current employer. Once that is done then your new policy will take affect without any laps in time. From that point you can make an appointment with a surgeon such as Dr. Oakley or Dr Valentine depending on where you live. I used Dr. Oakley. They will have a consult with you. Talk with you about what surgery is best for you. And then start the process from there. The secretary that works with insurance is very good and knows how to get around the hoops with those insurance companies that usually deny the surgery. Like I said I was approved in five days. Its all a very simple process. Dont listen to everyone and dont tell them your thinking about WLS Surgery. Just obtain it for your own good. You can view any policy exclusions before you sign the final approval to know if there is any exclusions. Let me know if you have any other questions.
Hello again,
I just talked with Barbara, she was very surprised that they approved your surgery, she thought that BC/BS would not. She is sending me out the paper work and said lets give it a try, if it worked for you maybe it will work for me. Do you think it is the gal at Dr Oakley's office that knows how to write up the letter that gets it approved? I am excited, I hope I have as good of luck as you did. Thanks.
I apoligize for not getting back to you sooner. I just got home tonight from having my surgery. Everything went well I am just very sore. Barbara is a great lady. She will get you all set up on the correct plan. Now after you get approved make an appointment with Dr. Oakley's office to have your consult. Jennifer the secretary assistant will write up your letter to the insurance company explaining why its a medical neccessity. If you look online at your insurance policy that you will be getting and also when you get the insurance paperwork it will have an exclusion in there that says only if its med necc. Good luck and I hope this all works for you. Just be honest with Dr Oakley and his staff regarding your situation and they will do what they can for you. Who knows maybe in three months you will be writting me the night you come home from the hospital. Good luck.