Word of "warning"...

  Take this for what its worth...grain of salt and all.

I work for a 'small' company.  We have pretty decent benefits for a company this small.  Anyway...over a year ago when I started the process of investigating if WLS would be covered, I decided to keep it to myself.  Lots of different reasons, but mostly because to be honest, I didn't trust my company to not tweak the insurance policy.

I finally cracked after 4 months of asking work off in the afternoon once a month for my monthly visits for the pre-approval diet, and told my immediate boss.  She is very trustworthy and I knew she would keep everything to herself.

The end of August, I get my approval letter.  Surgery was in October, 2009.  I'm just over 6 months out and down 91 pounds from my surgery date.

Today...I find out that we are having an insurance meeting tomorrow because we have to all resign up for our benefits.  Why?  Not because we're changing companies...but because they are changing plans within the company.  My boss (the one I told what was going on) called HR today to find out why on earth we were all having to do this again...to find out that they are changing to a plan with 2 new exclusions...and one is Bariatric Surgery.  

WOW!  I guess my paranoia was not completely unfounded.

I just wanted to say this to anyone who is going through the process.  Be careful.   I guarantee had I not gone through the process last year and probably raised flags, they would not be switching to a plan that didn't cover WLS.  The company probably never had to pay out on one before and because I've had such great (and visible) success I'm betting they are afraid they'd be paying out on a lot more.

Kudos to those of you who don't have to have this worry...but this was a BIG eye opener for me.  I was worried I was being too paranoid last year....I guess not.

Hi Jenn,

Elec here :).  Yeah my boyfriends company wrote a clause in their policy that excludes WLS.  So if push comes to shove with all this, we might move him to mine if he decides he wants to do this.  I think he needs to see how well I am doing right now, although being my first week out, not the best week, but I am hanging in there.  Grats on the loss so far and hopefully I will get to see you at Warlord.  That will be my first event after all of this.

 Hey hon.  I had no idea you were doing WLS.

Good luck!  Take it easy and we will certainly be at Warlord!

Nearly the same thing happened at my company, we went from paying for medically necessary WLS just like any other surgery, to only paying 50% if it was WLS and it still has to be medically necessary.  I wasn't the one to start it all, but I was one of the last to squeak by under the old rules... I went under the knife on 11/28/05 and the rules changed on 01/01/06... whew.....

HI Jenn -
Just wanted to say - decades ago I was Fiora di Cava with the SCA. Good times!

 YAY!  for SCA people!  You should come back out sometime.

Shawn, I have read on OH that they can help fight the insurance monsters for you...worth a try.
I had a heck of a time finding a doctor that takes Medicare.
I found David Kim, then he quit taking it, and now he's taking it again. AAaaarrrrgggghhhh!
But now I am working with Michael Green!!!!!!
Dr. Kim's loss.

 you're lucky you got in before the change, my husband's employer never allowed any kind of weight loss expense, not surgery, pills, diets, gyms, nothing. We paid cash out of pocket and I can just say, it was worth every cent and I feel so sorry for all those people we see at annual mgt. meetings who so badly need wls or something of the kind. This company is not little, they have otherwise very good benefits, but they won't pay for anything like my gastric bypass, no matter what your doctor says, no matter how many doctors recommend it, but they will pay for alcohol treatments, smoking treatments, and mental illness treatments, plus, they would gladly pay for my diabetic meds for the rest of my life. Can anyone ever make sense of this?

I hear ya, I had been going through my process since 2000 and got denied three times, after the fourth time I chose to keep it to myself and well I had my surgery on the same day as you.  Your advice is very justified, the insurance companies include WLS however, the companies can include that in the exclusions, there are not many they can include, but WLS is one of them.

Thanks for the tip
Gina