Kansas Attorney?
Getting an attorney to force an insurance in Kansas to pay has been tried plenty of times. Especially Blue Cross with no success. If there's a writer that excludes it then that's it. It simply isn't a covered service. I know that's not what you wanted to hear, but I just thought I'd tell you before you go spending a lot of money on an attorney.
Do you think instead of a lawsuit against BCBS or other insurance companies, maybe the lawsuit should be against the company that wants the exclusion? I think the mistake is going after the insurance companies, because there are a growing number of insurance companies that seem to want the coverage, but because of cost individual companies or the state in my case choose to write in the exclusion. If the insurance companies could make more money by charging more for premiums to add coverage for surgery they would do it in a heart beat.
So I say a lawsuit against the company who has written in the exclusion has a better chance of being successful. Bottom line is the exclusion is discriminatory in nature, WLS is really the only lasting proven method to fight obesity which most doctors now agree is a disease and an epidemic. If chemo is the treatment for cancer, a cast the treatment for a broken bone, sugery and removal a treatment for a apendicitis, etc. etc. then why isn't our treatment being covered? It would be different if the companies offered multiple plans to chose from where at least one plan offered coverage of the surgery, even if more expensive, but they flatly exclude coverage whatsoever. I think it's illegal to deny a proven treatment method for any disease. Isn't the reason we have health insurance to provide coverage for us when we are ill?
The culture of exclusion seems embedded even in our state house. I have contacted local legislators numerous times to get this coverage introduced, but the reception is never faired well. There is some good news is that after the healthcare intiatives and anti-obesity programs introduced this year, they are going to "study" the results and give recommendations to the Governor's obesity comission. We can only hope that this on the comission see that the simple eat better and excersize more preaching isn'[t doing any good and they have to do alot more to combat obesity and they might actually have to look at proven treatment methods.
Just my 2 cents. It's a long hard road, but we are never going to get anywhere unless someone in this state works it through to the end. Too bad I don't have the money for the fight either. You would think the obesity action network would be more involved.
I think your probably right here. Someone else has made this suggestion before in another thread. I think going after the state who makes the policy is probably the best bet for success. Even if you don't work for the state because the state is allowing this condition to exist through discriminatory policies. Going after ones employer in court though can be problematic in itself for obvious reasons. Someone also said they've tried going to the insurance commissioner but she doesn't return calls or answer e-mails. Another problem is there is still to many people in this country who have the "fat lazy bast**d mentality" and think all obesity is caused by gluttony and laying on the coach. So finding true empathy from colleagues may be difficult as well. Perhaps the best thing to do is what we all hate. Put ourselves out in public scrutiny. But if we make enough racket and ring enough bells then maybe something will start to happen. If we make it known there is a solution with little access then I think we'll find friends to help make us even louder. 1 1/2 hours of surgery will make us all go away. I think Obesity Help can help with this. They make arrangements for parties at various places and cruises and the like. Why not rallies?
Your right. Why not? Why can't we march on the statehouse lawn? It is hard to put yourself out for public scrutiny though. Esepcially when there is so much of that "fat lazy bast**d mentality" that we have to fight.
One should have protection if they speak up against their employer, and the employer comes out against them. Then they can be sued for retaliation.
BTW, I am thinking about trying to go to law school now, not just because of this, but it helps motivate me even more.
Who is your insurance company? Did you contact the nurse for Kansas area of your ins? They are the ones who determine.
Took me three times of dispute and great west paid most of my surgery. I know my regular doctor, Edalati, was very supportive and instrumental in my getting the surgery.
Contact the NURSE for insurance company. I had them send info.