Another Insurance Rant...

Hi All, Just want to warn all of prospective WLS patients out there that the insurance fight just got worse. This year Aetna, BSBS and a lot of other insurance companies automatically excluded WLS from their plans unless there is a rider to the contract with your employer. Aetna told me my employer would have to decide if my surgery would be approved. My employer said Aetna would have to approve it. Huh? So I sent a letter of pre-determination to Aetna and sent a copy to my employer. Our insurance is self funded and I can't remember if that is going to hurt or help. I see a doctor specializing in eating disorders in a couple of weeks. She also is connected to the Wellness Institute at Northwestern so she will be able to help me more than my PCP. I just want to do something. I like to take action instead of dwelling. My PCP thinks my anti-depressants are causing the weight gain. I told him I was being treated for PMDD and I would end up maiming my husband one month if I went off them. They have literally saved my life. I hope this new doctor understands a little better that him. In the meantime, I'm taking it day by day. The irony is if I lost my job and insurance I could get the surgery under Medicaid. Am I the only one perplexed by this?

Hi Cindy, NO you are not the only one perplexed by the fact that if I leave my husband and get medicaid I could have this surgery also. Why is it the working are always penalized! LOL Not saying others do not deserve the surgery..but how does anyone justify paying for insurance and then needing a procedure and HAVING to get approved for it, It is a contract I would think they would be liable for breaking the contract. Oh well I am going to keep plugging away until they drop dead from opening my mail or I get the surgery! I live in Virginia but insurance is in Ill. This is with a fortune 500 company my husband works for. I can't seem to vent enough! LOL Cherry

yanno when i worked for the gas co.(nicor nazi's)i had bcbs and paid a fortune for the privaledge to say i had it....BUT,,,,they suck....i was denied even tho i have many med problems resulting from it...they said they weren't serious enuf...sooooo long story short i got too fat to work and now have medicaid...i will be havin the surgery and going back to work