i need help/advice

What about getting a job???

Laura

I'm kind of agreeing with Dana and Mary...Your BMI is really high so there is really no reason for your Ins. Co. to deny if they have the WLS rider.  I would go to your Ins Co website and start scoping it out. I really did a LOT of research on the web and even was putting together a letter just in case I was denied. My Insurance Co. DID have a rider for WLS so it was a little easier in my case.

My Surgeon was ready to go to the mat for me if denied, so it's worth going the extra mile, doing your research, etc. I had a 3ring binder full o'info before I even went to the "Cattle Call" group meeting. Do your Homework on your Insurance Co. and pick a Surgeon who will go to the wall for you in case you are denied. Mine did for some of his patients who were denied, I was lucky...approved first time out because of comorbidities, but others aren't. But you gotta know if they will pay for WLS.

Good Luck

1) Is wls excluded by your employer or the insurance company? If it is by your employer go to HR and talk to them about getting it included!

2) Comming from a family of physicians I am appalled none of these Docs would help you with weightloss. I am not sure where you are but do you have any friends that have had wls, if so who is their pcp?

3)Go to some wls seminars! You should not have to pay a fee for these. Check out some wls Docs this way and many have a finance person to talk to you about the financialend of this!

Believe me this is worth fighting for, I was denied twice, had a surgoen move out of state and left me with no records in the middle of application process and fought for 2 years to have my surgery. If you have to fight for it you will want it even more.

In the meantime get the book "Weight Loss Sugery for DummieS" It is a great resource book all about the surgeries. Maybe use this time while you are waiting for your surgery to get yourself prepared for it mentally and Physically. Start with slowly changingyour eating habits (look on the most recent thread of QOTD for ideas).

Do not lose hope!
Meggie

here is a thought - you will probably have to have 3 to 6 months of document deiting - to prove you will stick to the plan I think - not real sure WHY they have you do that - my doc just asked me which diets I had tried and which ones of those I like best - anyhow

go and pay to join something like Weigh****chers so you can "prove" you were trying to lose the weight - so if hubbys insurance changes you have that covered.

you will probably do an all liquid diet right befor eyour surgery - your bmi is high - I am 5 4 1/2 and my highest recorded weight was 425

start walking as much as you can - I too was a healthy fat person most of my life - till I hit my 30s and started bit by bit falling apart LOL - if you are already active keep it up -

do yoru best to act like you WILL have the wls of your choice SOON

best of luck
Danni

Basically, WLS exclusions are iron clad....sucks but true, the only exception would be if you were in california and then maybe (big on the maybe) you'd have a chance because their external appeal process seems to favor patients. My advice would be to self pay for the DS (if you can afford it). At your weight, it's the best possible surgery available. I was almost 500 lbs when I had the DS, and got to goal (under 200 lbs) in 18 months. There are several DS surgeons outside the US who charge under 15k (someone...i think raven... just posted about this on the DS forum), and some inside the US that charge about 20k.

Scott

thanks everyone for giving me advice. ill try everything.

one quick thing though, i keep seeing that if my insurance had a "rider," what the heck is a rider?

You may have to wait until you've saved up the money.

Research the other insurance companies available through your husband's work. Find out which ones do not have an exclusionary WLS policy. Also, I would guess that that is your husband's employer's policy as I know of people with S&W insurance that have had WLS. I second the suggestion of going to HR and finding out if that could be changed.

Also, as someone else pointed out, some insurance plans require a 6 month pre-op diet. Even if the new insurance won't kick in until January 2011, you could start the diet with WW in say June, so that by the time the new insurance kicks in, you've done the diet and all you have to do is go through the approval process.

Have you tried applying for other loans? There are several companies that offer medical loans. Perhaps one of the others would approve you?

The only other option I can think of is, if you are physically capable and able to do so, perhaps get a job (part time or full time) and put all of your earnings towards savings to pay for the surgery.  It would build that much more quickly. 

this has already been said but at your BMI you do not need comorbidities....though if you do not act soon you might!  You know though ANY doctor I have gone to in my life has mentioned losing weight to me for my whole life.....so I am shock you would go to several at your weight and they will  not help you......go to another one!!!  and as suggested go to seminars....finding the right surgeon is important!!

ok so i took the advice and i read through the whole handbook of my insurance policy. this is what it has to say referring to WLS:

14.39 Weight Reduction

Weight reduction programs, food supplements, services,
supplies, surgeries including but not limited to Gastric
Bypass, gastric stapling, Vertical Banding, or gym
memberships, even if the participant has medical conditions
that might be helped by weight loss; or even prescribed by a
physician are not covered.


well, now what?