insurance says gastric is a exception HELP

My insurance company says they won't cover surgery.  It's an exception.  Is there any way around this?

It's going to depend that type of insurance you have...

If your insurance is through an 'employer' and is self funded (meaning it's the employer's money)... I'm sorry to say but no there is no way around this..

If your isurance is not through an employer and is a RISK account (it's the insurance company's money)... you may be able to appeal.

Good luck !!

I had an exclusion on my policy too. My employer had no control over the exclusion because we have a small business plan.

If you don't have any luck with your current coverage, you could try what I did. I canceled my plan thru my employer and purchased a self pay plan with GHI*. It was $415 per month (my employer paid) and they covered my band 100%. They do require a 6 month supervised diet before surgery.  It is a bare bones policy and didn't cover office visits but I waited until the last possible moment to change plans. I got most of my pre-op stuff covered under my original insurance. (Anthem BC/BS) I did have to pay for a few visits out of pocket but it was way better than self pay for the whole thing. I switched back to my original plan during open enrollment a few months after surgery.

* NY is a little different than most states in that you can purchase an individual plan even if you qualify for group coverage. Just make sure there isn't a gap of more than 90 days between plans or they can deem obesity a pre-existing condition.

You have options. Good luck! (send me a msg if you need any help.)

Its getting more common for Employer's Insurance to not include some procedures...The employer wants to save alot of money and the premiums they pay is alot lower if RNY isnt on it...I bet in the future its gonna get more common, so if you are thinking of having RNY or lapband you should do it now. 

I know my company's insurance plan doesnt cover it anymore after 3 people in my company had RNY over past 3 years...I was the last one, and I'm freaking happy I did it