Devastated

Take a look at your policy and read the exclusions.  If "surgery for morbid obesity" is on the exclusions it will be a tough fight.  I experienced this previously in an attempt to get approved for surgery.  I had BCBS but my company had a small cap policy that was regulated by the state health care commission which did not have to abide by state mandated laws.  Years ago my state - MD was one of the states that passed the law making it mandatory for insurance to cover weight loss surgery if medicaly necessary.  I followed this as far as state representatives and legislators.  However because my policy was small cap it was still not covered.  My company would have had to purchas a rider on my behalf for the coverage. 

It wasn't until my company grew larger and went into the next tier of policies on BCBS that FINALLY after looking every year on renewal at the damn benefits book...it finally said yet still in the exclusions section....surgery for morbind obesity, unless medically necessary.

I jumped on it as fast as I could.  I found out that under this new policy the medically necessary includes everything you would think typical for surgery -  BMI of over 40 and in some cases over 35 with co-morbidities.

There were other stipulations as well.  Mine was 6 months of proven weight loss/diet attempts with a legit program.   If you do not have the 6 months history to provide that was in the recent past, they require you to do the 6 months of whatever program you choose and then to reapply for approval. 

So I would find out if you have an exclusion, if so is it flat out not covered or does it mention medical necessity,  if it mentions that, what are the stipulations and what other history are they looking for...find out exactly what you are up against and take it from there. 

Something you have to think about is if your company actually has that coverage.  Just because the insurance company may cover the surgery doesn't mean that your employer does.  It is written into the policy that my company purchased.  That being said, I have BC/BS of KC (really, South Carolina), and I was recently approved for revision to VSG when it had been verbally denied back in January.  I kept calling, talking to people, and sent a personal letter in with my records and request.  Amazingly, it was approved.  I just had my band out today, and I will be getting the VSG in May.  So, don't give up; you can appeal--just call the company and ask for the appeal paperwork.  I had already done that in aticipation of beind denied. Good luck!
Jenn

Don't despair yet, I was denied 3 times before getting the OK. Each time it was merely a matter of the ins. co. needing more info. Find out why they denied and then take it from there. Best of luck!

Did your insurance company deny you, or do you have a policy that does not cover WLS?

There is a huge difference.

If your company does not pay premiums for WLS, there is no appeals process.

If, however, WLS is paid for some people, but your particular case was denied, then you should have an appeals process that you can follow.

Is a part-time job an option?  Starbuck's insures their part-time employees - and their policy covers WLS.

if you need help on how to phrase your co-morbidities, this is the board to help! Just reach out when it's letter writing time.
 

First let me say  thank you to everyone who posted a comment on my last post. But sadly, my insurance does not cover any bariatric treatment whatsoever. I've been on the phone all morning and the answer is nope. That being said, it isn't BC/BS but rather my employer. It is how they have it underwritten. So I inquired about the self-pay option. I have to pay the $18,000 up front, period. No pay plans nothing. Soooooooo doesn't look like I will be a bandster. I am very disappointed all the way around. I have checked advocacy groups etc... but there is nothing in my area. It's really sad. So it's back to trying Adipex, WW and continuing my walking. I am having a pity party for myself; here I am 50 yrs old wondering if I will make it to 70. I normally am not a feel sorry for yourself kind of person, but this was a hit below the belt. Maybe I should audition for the show HEAVY. LOL.