Darn Insurance Companies...Help!

I was wondering if anyone can give me advice on how to get an insurance company to cover the surgery. I have Healthlink (Wausa) and they say there is a exclusion in my plan but there has to be a way around it. Any advice?????

Hi Kate, Where I work we are in the process of open enrollment for different insurance - does your company offer anything like that? I know how difficult the insurance companies are. When I had seriously decided to have this surgery, I called my insurance company 2x and talked with 2 different people and was told that my plan had no coverage for this type of surgery. I then called the surgeons office and talked to one of the girls that deals with the ins. companies on a daily basis. She told me to fill out the paperwork and send it in to them. I did just that and told God...if this is meant to be...then it is up to you. Then I just kind of forgot about it. Imagine my surprise when the surgeons office called me 1 month later and told me that I had been approved. My advise is to let the surgeons office pursue the insurance company and find out exactly why there is this type of exclusion. They may be able to help you because they deal with these types of situations all of the time. A friend of mine has blue cross/blue shield and she has to wait 1 year - during which time she has to be on some kind of diet plan that is supervised by her Dr. - whom she has to go see every month. She was not happy but, if she truly wants to have this surgery next year, she has to comply. I am having my preop tests in the morning - my surgery date is October 18th. I am nervous and sometimes find myself asking - what am I doing... Good Luck Kristi Hanson

Kristi... I have to say that your reply was sure refreshing. It almost sounds like my situation. I have called 3 times and they always say no. Before i even looked into the whole WLS my doctor suggested i go to a dietician. So when i called my insurance company to see if they would pay they said no. I went ahead and went anyway and next thing i know they paid for it. I dont understand that. I guess there is hope after all. Im trying to stay positive and hoping for the best. Thanks for that reply. Did make me feel better. Also good luck on your surgery. If you feel like talking feel free to e-mail me. =) Kate

hey kate! i'm sorry to hear you're still having trouble with your insurance company. i wish i could give you more information than i already have, as that doesn't seem to have helped. i'll keep you in my prayers and hope that it will work out somehow. see you monday! tracy