question specific to Indiana and weight loss surgery insurance coverage

I know there's a forum dedicated to insurance coverage, but I wanted to post this here since this forum is dedicated to Indiana. We live in Indiana and my husband works in Indiana but the headquarters for his company are in Missouri. Our insurance excludes bariatric surgery coverage. I am curious if anyone here has had experience with having surgery approved on a plan that excludes bariatric services because of the law Indiana has that encourages employers to cover it.

I have been fighting having the surgery for 10-11 years because I wanted to lose weight on my own without surgical help. I have lost 120lbs on my own, but I have hit a plateau for almost a year even after changing my exercise/eating plan multiple times. I haven't been under 200lbs since I was in 4th grade so this has definitely been a lifelong battle for me. I have multiple weight loss attempts through different doctors, weight loss centers, dieticians, and weigh****chers. Although I have had some success I am still about 180lbs overweight with high blood pressure and asthma.

I think I'd check to see if Missouri has any state laws similar to Indiana's. Other than that, I really don't have any insurance advise for you.

I did want to commend you on your weight loss efforts. I have had a multitude of problems stemming from my RNY, plastics, etc. Because of that, my daughter absolutely refuses to even consider WLS even though her BMI is significantly higher than my highest ever was. Some advise I have given her to lose it non-surgically (an no, she has yet to consistently apply mom's advise) are:
1.  Drink ALOT of water. The old stand-by is 32 oz. I would recommend you double that if you can.
2.  Drink NO caffiene. If you do, for every ounce of caffinated beverage you have, drink 2 ounces of water IN ADDITION to the water you drink in #1 to counter the effects of the caffiene.
3.  Substitute all the foods you presently eat with a lower fat/sugar containing one. There is nothing saying you can never have Mayo on a sandwich again...but use the low fat one. In other words, cut calories without cutting out the food. You won't feel like you are depriving yourself then.
4.  Cut down on how much you have. Love chocolate cake? Fine...eat a slice, not a half a cake. Self control is a very hard thing to learn. Surgery or not, it is one that you will have to learn in order to suceed.
5.  Start every meal with PROTEIN. Protein fills you up faster. Eat 3-4 oz of it. Then your veggies..then your fruit. IF you have room at this point, then have your carbs. Make your carbs a colorful choice! White carbs are your worst carbs!
6.  Here's a hard one...do not drink anything 30 minutes before or after a meal..and none while eating the meal. Let your tummy fill up on the food and keep the food it there. It will satisfy you longer.
7. Chew slowly. It takes 20 minutes for your brain to get the message that your stomach has had enough so chew slowly to give it time to get the message.
8. If you walk for exercise, dance! If you run, bike! Change it up! Use different muscles.
9. DO NOT SKIP MEALS! ESPECIALLY BREAKFAST! People think that losing weight means cutting down on meals. WRONG! It is cutting down on amount of food per meal. 6 small meals is healthier for you than 2 large meals even if it means you are getting in more calories per day. Breakfast just starts your metabalism for the day. VERY important! Also, if you don't get enough calories in your body goes into starvation mode and doesn't want to release the calories it is getting in...which means instead of buring fat, you burn muscle.
10. The most important word to weight loss is PEW. Protein...Exersize...Water

Knowing the problems I have had, if I could go back and do it again, I would be going through steps 1-10.

Good luck! Don't get discouraged. Even post-ops go through stalls on their weight loss. That is the time when you can't let yourself get discouraged but continue doing what you know you should.

Sherri

I just wanted to thank you for your long reply and let you know that I found out today my insurance will cover the operation even though it says on my policy that they don't cover bariatric services. The surgeon's office called me today to tell me they said I have coverage for it and wanted to schedule my first appointment. When I asked about coverage because I didn't think I had it she actually told me I have to specifically tell them it is bariatric services for morbid obesity not just bariatric services.

Anyways, this surgeon requires 6 months of supervised diet program through them before they will do the surgery and they said that's because they had so many insurance companies that require it they ended up adding that as part of their program to get people ready for surgery. So my first appointment will be on February 21.

Thanks again for your your tips!

You're quite welcome & good luck!