i need help/advice

ok so i need some advice on what to do or some help, whichever. im 28, 5'6" and weigh 450. i have no co-morbidities. i have scott and white insurance. i have tried getting WLS through them but they deny me even before i can start the process. i asked if i could self pay but they wont even tell me a price without seeing the bariatric doc. i have gone through 3 different PCPs. not one of them will help me out with any kind of program. i get into the office, ask about helping me with my weight, and they just tell me they cant do anything i have to do it alone. so no doc will help, and insurance wont help.
one doc did send me to a nutritionist. but the diet she put me on had me eating so much food at each sitting i ended up gaining 12lbs.
i find dr. zapata in monterrey mexico. i send in the applications. he said i was approved and i just needed to pay $9500 and he will set me a surgery date. im saving all of my money for that and so far i have about $2000. i dont have a job, but my husband has a really good managers position with a grocery store here. weve tried getting a loan but got denied. cant change insurance companies until october but then it wont go into effect until jan 2011. then wait another 6 months for approvals and all the doc appts.
i researched texas bariatrics specialists. they sound good so im going to try them.
i cant get medicaid/medicare because im only 28 and they said dont waste your time applying because youll get denied anyways.
so my problem is what do i do now? ive exhausted every angle i can think of. i need some advice. can anyone tell me what to do next.

Have you checked with your insurance company to see if they pay for WLS?  Most insurances if they have the rider for WLS don't require co-morbidities with a BMI of over 40.  I'd start here, I see no reason why a doctor would not do WLS on you if your insurance pays for it; especially since you qualify based on BMI.

Are you willing to travel?  Maybe look in Austin or surrounding areas, or even consider driving to Dallas.  Here is a link of WLS surgeons in Texas (it's not inclusive of all, only those that pay to advertise on OH).

http://www.obesityhelp.com/forums/TX/a,doclisting/type,46/


Whatever you do DO NOT give up. 

Best wishes,

With your BMI being in the 70ish range, Cajungirl is correct, most insurance companies should cover it even without co-morbidities.

I would suggest going through the appeals process with your insurance company. You have the right to appeal any decision they make regarding your health care. It might take them denying you a few times, but appeal it each time and provide documentation by way of your health records to prove to them that you are morbidly obese and need them to approve WLS for you.

I hope others post with suggestions for you as well. Good luck on this process.

Hey! I am right down I-35 from you about half way to Waco. I was a self pay and was able to find out the prices from many doctors before I made my decision on Dr. Kim in Dallas area. Some of them even have it posted on the websites.

 HI Dr. Kim is in Colleyville but does surgery in Dallas.    His website is drdkim.org if she wants to check out his website.   You look great !!!!


Hugs and blessings ~~~ Vivian

Have you actually sat down with a bariatric surgeon? It would be worth the self-pay out of pocket amount to get an opinion and to have him submit documentation to your insurance. At 450lbs you have some co-morbidities. There are things that I hadn't thought of as co-morbidities until my surgeon documented and wrote them up for my insurance. 

Don't give up. Appeal, change insurances, etc et****il you get the answer you want.

Good luck!!!

yes. i saw john alexander in dallas. he wanted $11000.

what co morbidities do i have? i dont have diabetes, sleep apnea, HBP, heart problems, gerd, etc. i never knew there were other things. please tell me......

Check out this site, it might give you information.  I would bet with testing a doctor can document some health problems due to weight.  Is there any health issues in your family due to obesity?

Dr Alexander was my dr.  One thing I know he knows all the tricks in the book to get insurance to pay.  He also has programs if you can't pay.  He is a stonge believer.  If you are that heavy you are bound to have co morbidities.  And he knows them all.  I can't believe he didn't come up with some sort of program for you.  He does free surgeries and also has grants.  Go see him again. 

the thing about the insurance is they wont even let me apply. its in the rules that no form of WLS will be covered whether medically necessary or not. they would rather have a person go through heart kidney issues, breathing problems, anything that goes with being overweight then paying for a surgery to fix it all. basically im a healthy fat person. i guess my only option is too just wait until i have saved enough money. this is so frustrating. being fat sucks!! :)