Hopefully this is the first of many posts!
I have been on this website so many times and have learned so much. I have been doing a lot of research concerning WLS, and want it so bad. I have my days of ups and downs concerning insurance. I have read my policy from front to back and they exclude any kind of procedure/drugs for weight loss including morbid obesity. Sure wish there was a way around it.
I have been to a weight loss seminar and I do have an appt set up for the 23rd of June. I can only go and see what takes place. I may have to go back to work for a company whose insurance covers the procedures. Oh well, I only hope and pray for the best.
t'resa
on 6/12/05 11:44 pm - ~~, LA
on 6/12/05 11:44 pm - ~~, LA
Hi,
That is terrible about the exclusion. From what I have heard, if you have an exclusion for wls in your insurance contract then there is no way you can get your insurance to pay for the wls. That is just what I have found out by reading posts on here and I know I have ran into a brick wall when dealing with my insurance company on other issues where they had exclusions to certain procedures.
Attend the wls seminar and maybe they can offer you more info on this.
Take care and hope to hear back from you,
T--resa
I was able to attend a WLS seminar a couple of weeks ago and will go in for a consult next Thursday the 23rd.
I do plan to fight this! I can be a little when need be. I will be going through my husbands employer concerning this. Since UHC just follows the policy of what the employer purchases I know fighting them is a lost cause.
Since my husbands employer is somewhat small and this is really a self insured policy I feel strong in my fight. My husband works directly underneath the owner of the company. Part of my fight will be if something happens to me my husband will not be able to continue working and traveling the way he does. He is gone at 3-4 days per week and on call 24/7. Won't be able to that with three kids at home and no one to watch them. So in my opinion this could be a win/win or a lose/lose situation. I have so much documented information concerning the negatives of obesity.
A while back I tried to get a prescription for diet pills filled and of course my insurance denied it. When I got home I was going through the list of covered prescriptions and they will cover Viagra. Go figure! I did a little research and have found no documented cases of a man dying from lack of sex. Of course that will be part of my ammo also, if all else fails. I even called UHC and believe it or not they will cover a penal prothesis.
I feel like I have a good fight on my hands. I am usually a little to deal with but I may have to turn to my other side a little
Anyway I guess I kind of vented a little hope that was ok.
I just love this website and reading all the post!
Have a happy day!
JC
t'resa
on 6/17/05 1:28 pm - ~~, LA
on 6/17/05 1:28 pm - ~~, LA
JC,
Keep up that attitude and I do believe you will win the battle in the end!
And don't worry about venting...we all do it. That is what we are here for...a little support, a little of just listening and even some cheerleading every once in awhile.
I had some frustrations today...will probably vent this weekend when I boil over. Trying to keep my cool about things and trying not to rush everybody into doing what I need them to do. My docs who were supposed to have my letters of recommendation for wls ready today have postponed getting them to me until next week from my pcp and in two weeks from my gyn cause he is going out of town. Well, by then my surgeon will be out of town for a week. So, go figure! They wanted to submit next Tuesday before they went out of town. Now it will be at least two weeks before they will get the chance to do it. (big sigh) Oh, well......I can't make them go any faster than they want to. And my gyn is doing me a big favor so don't want to alienate him any more than I have to. At least not until I get my papers...
Well, take care! Hope you have a great weekend!
T--resa
Thank-you so much for your support!
Good luck with all your paper work, it is such a shame that there is so much red tape involved in this. I will be thinking of you this week.
I have not talked with my pcp yet concerning WLS. I did talk with his nurse and she kind of talked to him for me. He is not real big into WLS. I really like him as a doctor but he has that mentality that I just need diet and excercise. I do plan to change his way of thinking! Depending on how things go Thursday with my consult I may have to go in an talk with him and get his support. I'm sure he will support me if I asked. I called my gastrointerologist and requested a copy of all my medical records, (a lot of documentation concerning GERD and ulcers) I am hoping that might help somewhat. I also plan to talk with my GYN, I know he won't have a problem writing a letter for me. I have only been going to him for 24 years.
I guess I can feel your frustrations and knowing I will be right there with you in doing my own fight. .
Thank-you so much and have a great weekend.
JC