Insurance Questions - Please Help :help:

I've decided like many of you to have WLS. I currently have Regence ValueCare (BCBS of Utah) on an individual policy as my employer does not offer health benefits. In my policy it lists WLS as an exclusion. I've talked to my insurance agent and he says that sometimes they will approve WLS if it is proved medically necessary. My questions are: 1. Has anyone been in a similar situation and been approved? 2. Where WLS is written as an exclusion should I go through the appeals process or am I setting myself up for devastation? 3. Are there any other resources to pay for WLS without having to take out a loan? 4. As an exclusion I know I will be denied at first. Should I contact my insurance and ask them about WLS or should I just have my WL surgeon's office submit the paperwork first? I could really use some help and hope that someone out there has some answers. Thanking you in advance, Christine

Hello Christine: I'm sorry to hear that your heading down the dreaded "will my insurance cover it" road. I have IHC and they refussed everything I tried to do to get them to pay for it. I finally had to self pay in Mexico. It was a wonderful experience and I wouldn't change a thing. I had a better Dr. there than I do with IHC. I think IHC owes me a debit of gratitude in that I'm off all my diabieties meds and my high blood pressure meds. My next goal is to get off the C-Pap machine. I'm saving IHC a fortune!!! Good luck with your appeals. I'll keep you in my thoughts and prayers. Tami~

I am also looking for funding. I also have IHC, and they have been NO help, although they pay for CPAP, oxygen, Congestive Heart drugs, blood thinners, heart medications, etc. My oxygen needs alone cost in excess of $300 per month. I cannot work, or even walk about much. I have even gone before their board, only to have one of their doctors say that it has never been proven that asthma (which I also have) responds to weight loss. Even the others at the table looked askance at that utterance! I also have Medicare (due to disability) and would like to find out if they will pay. I just don't know how. Anyway, Mexico is probably not an option for me, but I would be interested in hearing more about it and how you are doing now. thanx, maribeth