Ins Denied Referral but having Eval appt anyway 3/3

I really thought (or expected) that my insurance would at least cover the other portions of the clinic costs -- especially since they are not JUST a surgery center. I should probably appeal it. I am one of those lucky state workers -- thankful I have a job and job security, but geeeeeez, kinda teed off right now. Anyway, just called WW and got my evaluation appt with Dr B for 3/3! Yayyyyy.

Lisa J

Just a thought but my insurance totally excluded weight loss surgery but...they covered my lab, cardio stress test, sleep study etc.  I had all the labs run through my pcp.  Weight wise can tell you what they want run and your pcp's office or your lab can do them.  I think they would have to cover them in that case.  They don't have to be coded for weight loss pre-surgery etc.  Way to go with your appointment and evaluation.  There are a lot of us that were self-pay.  It has been so worth it for me and many others.  YOU ARE WORTH IT!!!  I save about 2-300 per month just on co-pays in doctor visits and prescriptions.....Good luck!!!

I hadn't thought of that route, thank you for the info! My PCP is the one that sent the referral to the insurance co and you'd think that their head MD would know it's not just a surgical center. So yeah, then I can definitely feel better about this right now.  Thank you for your support and your insight and all your cheers and back pats! Fortunately I'm only on one med and it's a cheap one so I've been very fortunate with no other co-morbidities that cost $$$$ every month.

THANK YOU THANK YOU THANK YOU ALLLLLL

Lisa, I would appeal it. I know my mom is a state employee and her insurance doesn't cover wls at all. It is excluded on  every plan they offer in the deparment she worked for. She retired in June. I hope you get it worked out. I will be saying prayers for you.
emily

I will appeal even if I can still get everything covered through my PCP anyway...JUST BECAUSE! 

Thank you so much! Prayers are always appreciated!

Lisa J

I was self pay, and I know it was the best thing I ever bought for myself.  It still annoys me that the insurance company wouldn't pay, but so be it.  I think one day that will surely change, but only when they realize the surgery is cheaper than paying for the comorbidities.  Like you, I really didn't have any, other than the fact that I could not walk-but that was due to food problem, NOT my weight....LOL.  So, I had my foot fixed on THEIR dime, and the weight fixed on mine.  I'm just grateful I was able to do it.