HELP!! NEED INFORMATION PLEASE
Hello Teri: I actually purchased the supplemental policy, but as yet I haven't heard from anyone on this board as to whether or not if will cover. My agent tells me, "as long as it is medically necessary and the first gastric bypass was beyond 5 years." He promises me that it will cover. This is a limited policy and only covers up to $50,000 which should be more than enough for a reivision, but all these insurance companies have their cop outs. On their exclusion policy I don't find anything that says they don't cover Weight Loss Surgery, but I haven't got my full policy in the mail yet. I have a 30 day cancellation if not satisfied once I receive the policy. This policy is $226.00 per month. I will let you know once I get it. Good Luck.
Well Janie, I might be caught between a rock and a hard place cause my policy now reads...."Benefits for Obesity Surgery are limited to one surgery per covered person, per lifetime, while covered under a Continental Airline Plan or have a BMI of 40 or greater and documentations froma physician of a diagnosis of morbid obesity for a minimum of five years, have a six month MD supervised diet and have a pre-surgery psychological evaluation." I have ALL of those things....my BMI is 46.5 and I have documentation for days. But they still denied my appeal saying I don't qulaify since I already had 1 surgery 14 years ago. (I have been with Continental Airlines for 18 years) I am trying to put together my second appeal now - but I'm not sure what more I can say - pretty much said it all in the 1st appeal. I'm now wondering about getting a lawyer to help me write my second appeal...don't know if that could help. Also, I am going to go to a different surgeron - one that I think will help me appeal to the insurance. I don't have much hope though I am going to appeal as many times as I can. but at the same time, I want to check out buying a supplemental policy - I want to get the ball rolling - tired of waiting! I actually started this whole journey last year in early FEB07. Called my benefits dept and they told me that I needed to switch to United Healthcare because they would cover WLS and revisions. So I started a 6 month doc. diet and began collecting all my paper work, etc.....changed my insurance elections in OCT07, had my psyc eval ...had all my ducks in a row when the new year rolled around. Made an apt with my surgeon for 1/3/8 and sent in all my paperwork only to be told that the policy had been changed......... talk about let down...... I am so determined to get the help that I need that I will do whatever I have to - even if I have to take out a loan and pay cash. Obviously that is last on my list, but I am really desperate. I am so tired of this fat body. And I am terrified of choosing another surgery that won't work. Like you said, I am reading everything I can find and see so many people that are having success, but then I hear of others that regain the weight. My cousin also had a RNY about 5 years ago and initially lost a lot of weight but then regained it all back. Also, since it is so hard to get a revision, if I ever get approved, I have to make sure that the next one is the RIGHT one. You said that your RNY surgery was sucessful for about 14 years, do you know what caused you to regain the weight? I really feel for you. It is so frustrating and not many people understand the feelings of guilt, failure, frustration, hopelessness,etc. ... even within the obese community. It seems that other people that have had successful WLS can't understand why anyone would need a revision..... sucks to be in that boat, but here we are, and we have to do something about it.
I believe that where there is a will there is a way. We just have to hang on to 'the will' until we find 'our way'! Never say never! We will get there!
Glad to know you and look forward to sharing our journeys!
Teri
