any help/ suggestions?

Hello, I just posted here for the first time yesterday. And it seems today my journey came to an abrupt end. The surgeons office called saying it was an exclusion in my policy. That there was nothing they could do and basically a very swift goodbye, cant help you. I cant be the only one this has happened too? What now? I am very upset and dont know what to do. Any suggestions I would greatly appreciate it. But thanks for letting me vent. Good luck to all of you Shannon

Shannon, DO NOT give up on having the surgery just because of stupid insurance. I, too, have an exclusion in my policy that was not going to be overturned. I did what probably not too many people do, and that was self-pay for the surgery (although I have a friend who did the same thing in August when her insurance wouldn't pay either). Now I'm not wealthy, far from it in fact, but I took out a personal loan for most of the surgery and paid cash for the rest. I compare it to purchasing a nice new car for yourself. Aren't you worth that much? Isn't your life worth that much? I started the process back in November of 2005 with the info meetings, and had my surgery in April 06. So far I've lost 90 lbs and couldn't be happier with the surgery and my results. My insurance did pay for the doctor office visits and lab tests etc., just not the actual surgery and hospital stay at Froedtert (I wouldn't go any where else!--Dr. Wallace and his staff are the BEST!). I have never regretted spending the money for a minute. Please consider this option! Keep me posted.

I, too, wasn't sure my insurance would pay, but the surgeon's office told me they would accept self-pay and told me how much it would be for an average 2 night-3 day stay. I had the surgeon you have listed and certainly did not find the office staff to be as cold hearted as you portray here. In the end, my insurance did pay so I was lucky. I have a friend who also had Dr. E about one week after I did last year and he self-paid and has absolutely no regrets. If you are out of appeals to the insurance company and can consider self-pay, there are loan options available. Capital One, I believe, has a health care loan program. I'm considering them for my plastics which I know my insurance won't pay for. The surgery is well worth the expense and Dr. E is the best! Their office has great aftercare and support which is so important. Kathy

Thanks for your respose Kathy. I dont think the staff is cold-hearted. Maybe she was having a bad day. Or as embarassing as this is I started to get choked up when I realized she was telling me there were no options I think she wanted to get me off the phone before I totally lost it. This is such an embarrasing thing for me. It took me so long to make the decision to call that I feel this is the last resort. If I could self pay I would definately do it. My health is worth it. But we are not in any situation to qualify for a loan. We just bought our first house this past August. I am so frustrated and of course that turns me to eating. But something has got to change eventually. I know this surgery could help in so many ways. Thank you again for your suggestions. I appreciate it more than you can know. Shannon

Hi Shannon, Hope things work out for you the have surgery in the future. My daughter was self pay and the one good thing about that is she could chose the type of surgery that she wanted (Vertical Sleeve) and the doctor. She claimed her medical costs on her tax return and got back everything that she paid in for that year. She then used that money towards her loan. Priscilla