New Girl - Confused, Insurance Question ... HELP!

Hey y'all! I sure hope that I'm posting this in the right place! I've been researching WLS for some time - and actually attended a seminar about 4 yrs ago, I left there crying my eyes out b/c at the time we had another insurance company and I was told that they were the hardest company to get to pay! I was devistated! I didn't even try to fight it... why bother!? Well, now I'm scheduled to attend a Seminar this Saturday here in Nashville - before I go I thought that I would call BCBS of TN to see if there is an exclusion on our policy ... and there is! Just what does this mean exactly? Does it mean that no way it will be covered? Should I even bother with going to the seminar, just to get my hopes up once again? Gosh, I haven't even started the process and it's already driving me nuts - I can only imagine the fight that some of you have had!! Thanks so much for your help! Stacye

Hi Stacye, and if you're in Nashville, you're on the right board. First of all, take a couple of deep breaths and relax. Attend the seminar, it's free. The knowledgeable you are the better you will understand things later. Things have changed since you attend the last seminar 4 yrs ago. Get a list of what all tests you will need to have done. One most likely if you have a hiatel hernia will be to see a GI Dr. start collecting all your medical records for the past 5 years. Make sure your PCP supports this surgery, if not you will need to find another one. Have your PCP put you on a 6 month supervised diet program (1800 cal.). If you have heart or lung problems, you should have those checked and be sure to get letters from all your Dr.'s and it must state MEDICALLY NECESSARY. Don't get your hopes down. Read today's quote that I just posted. All this will take you time, and right now you have the time. In January, I think it's around the 6th, there is a law on the books that makes all insurance companies pay for gastic surgery. It hasn't gone before a vote I don't think, but it will soon. The only insurances that the law won't affect or make mandatory is Medicare and TnCare. You are going to be busy getting a lot of this done, plus any that the Surgeon wants done and getting your records, the holidays are coming up fast. DON'T GIVE UP ON YOUR DREAM. It won't happen this year, but next year may be your time. I just found out 2 months ago that I have leukemia. I have been denied over the past year by 11 surgeons. But I haven't given up. I see my surgeon in Knoxville next week. I do know that those who have no exclusions in their BC/BS policy have to do the 6 month diet, most surgeons want you to at least lose 10% body weight prior to surgery. It will be easier on you during surgery and those are pounds that won't be coming back on. Stacye, the only dumb question is the one not asked. Keep us all posted on your progress. You can also see about financing your surgery. Some Dr.'s allow that thru them, or get a loan. But I would get on the internet and see about the law coming up in January that will make it mandatory for the insurance Comp. to approve the surgery. This is an obese nation, and it's time the government does something to help us. We elected them, now it's time to make them do their jobs for the people. DON'T GIVE UP ON YOUR DREAMS. May God travel with you on your new journey. Kathy

Hey Stacye What Kathy has told you is it !! Dont give up...... Good luck !! ML About Kathy Newton "The Dr. is in the house"

Now Missy, I put my Dr. back into the chest. Only take it out when necessary. LOL, Love ya, Kathy

Kathy is 100% right. You have to fight for this because this is your life!! Think of everything your doing as prep for when you will be able to have surgery. Nothing your doing can hurt you, it will only make your case stronger. So please don't give up, and good luck with everything that you do!! Jacqueline