Devestated
Don't take this as the end of the road!
I was in a similar position (not with Tricare) with a policy that had an exclusion for wt loss surgery. I appealed and lost- and lost all hope.
I then got recharged and started looking into other options.
Self pay was not something my MD would consider- they did not like it as an option in case something went wrong- then who paid? Me? Too much of a liability and financial risk.
It all stinks that we are at the mercy of insurance!
So,I decided to play their game.
I looked into purchasing a policy through Anthem BCBS or Harvard Pilgrim.
I was able to buy a policy of BCBS with an effective date of Oct 1. I had my surgery on Nov 5th and then termed the policy on Jan 1st. (By the way, my agent knew exactly what I was doing and why)
Kind of sleazy (I know) BUT, I got what I needed and did not feel guilty since the Insurance Company business is such a game.
I am now down 135 lbs and feeling super!
It all took a lot longer than I had hoped- but the end result was well worth it!
Don't give up!!!!
Carolyn
I was in a similar position (not with Tricare) with a policy that had an exclusion for wt loss surgery. I appealed and lost- and lost all hope.
I then got recharged and started looking into other options.
Self pay was not something my MD would consider- they did not like it as an option in case something went wrong- then who paid? Me? Too much of a liability and financial risk.
It all stinks that we are at the mercy of insurance!
So,I decided to play their game.
I looked into purchasing a policy through Anthem BCBS or Harvard Pilgrim.
I was able to buy a policy of BCBS with an effective date of Oct 1. I had my surgery on Nov 5th and then termed the policy on Jan 1st. (By the way, my agent knew exactly what I was doing and why)
Kind of sleazy (I know) BUT, I got what I needed and did not feel guilty since the Insurance Company business is such a game.
I am now down 135 lbs and feeling super!
It all took a lot longer than I had hoped- but the end result was well worth it!
Don't give up!!!!
Carolyn
Highest Weight- 306, BMI: 43.9
Current Weight- 168, BMI: 24.1
Goal Weight- 165, BMI: 23.6
Kudos to you, Carolyn! 
I was very lucky and only had a minor bump in the road on my way to approval for my RNY. I LOVE how you our-smarted the system and think you are brilliant! I agree that most insurance is a game and intentionally designed to make things so complicated that people do not get what they pay for. Glad it worked for you and hoping it all works out for everyone else who works so hard to make it to the losers bench.
~Donna
I was very lucky and only had a minor bump in the road on my way to approval for my RNY. I LOVE how you our-smarted the system and think you are brilliant! I agree that most insurance is a game and intentionally designed to make things so complicated that people do not get what they pay for. Glad it worked for you and hoping it all works out for everyone else who works so hard to make it to the losers bench.~Donna
Work like you don't need the money, love like you've never been hurt, and dance like nobody's watching!
Hello staceycarse,
Gov. Lynch signed a bill into law last year that requires insurance companies doing business in NH, to cover bariatric surgery - as long as the physician has issued a written order stating that treatment is medically necessary.
Go here to see if this is something you can go to your insurance carrier with:
http://www.gencourt.state.nh.us/legislation/2008/SB0312.html
wfmeyer
Gov. Lynch signed a bill into law last year that requires insurance companies doing business in NH, to cover bariatric surgery - as long as the physician has issued a written order stating that treatment is medically necessary.
Go here to see if this is something you can go to your insurance carrier with:
http://www.gencourt.state.nh.us/legislation/2008/SB0312.html
wfmeyer
wfmeyer is correct.
I believe former Sen Bob Clegg from Hudson sponsored the bill after he himself had successful bypass surgery. Not sure if Bob could help (no longer being in the legislature) but his email is/was [email protected] . Maybe he could help with info. If not, I would contact your state rep for assistance. Your ins company is probably hoping you'll lose heart and just go away. Fight on!!
I believe former Sen Bob Clegg from Hudson sponsored the bill after he himself had successful bypass surgery. Not sure if Bob could help (no longer being in the legislature) but his email is/was [email protected] . Maybe he could help with info. If not, I would contact your state rep for assistance. Your ins company is probably hoping you'll lose heart and just go away. Fight on!!
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