looking for advice on dealing with insurance

I have checked into bariatric surgery before but my insurance company said they won't pay for anything related to weight loss. I have Central States Health and Welfare insurance and I know there must be a way to get them to approve me. I have a BMI of 54. I have high blood pressure and hypothyroidism. I really want this surgery, I am so miserable the way I am. I feel trapped inside this huge body. I hope someone can help me, Jacqui

Hi Jacqui, I don't have any advice for you but there is a board on here that is dedicated to insurance issues. I went to that when I was originally denied for surgery and there is a lot of helpful information there. Best of luck to you.... with your comorbities you certainly have a case for needing the surgery. I'll keep my fingers crossed for you!

I would recommend getting a copy of your policy and reading it cover to cover. My insurance had a written exclusion for anything weight loss related, including surgery. If the exclusion is specifically in your policy, it is very, very difficult to get around. I was incredibly lucky because I discovered that I could change insurance plans (I work for the state and have several options for insurance) to one that covered weight loss surgery. Best of luck to you!

Good Luck Jacqui, I am going through the same thing and unfortunately my insurance BCBS says NO WAY! It isn't their choice, it's the agreement that my husband's company entered into with them, I guess to keep rates lower. Nothing that has to do with obesity or morbid obesity. Definitely post your question in the insurance section, I got GREAT advice there, even though in my case all the advice in the world couldn't help. In the meantime you can do like me and just start a little diet, pretend that you are working on losing the required pounds needed to get your WLS. Again, Good Luck!!! Jamille

My policy too said it wouldn't cover weighloss procedures of any type. But in the fine print under exceptions - "unless morbidly obese". I called the ins and they said they wouldn't pay, I asked about the exception and they said "oh you have to be over 40bmi and morbidly obese" I told her I was at 64bmi. They asked for a letter from my PCP stating that. I got the surgery, I was approved in 4 days. Good Luck

Jacqui: Have you ever considered self-pay? That's the route I ended up going because my insurance (and I fought them for 2 years) wouldn't pay either. I ended up finding a fabulous doctor in Texas who did my surgery. I had the Lap Band and I'm very pleased with my results so far. My weight started at 305 at my pre-op appointment and I am now down to 230 (in 4 months time). Just a thought. Michele

Jacqui, I am so sorry your insurance will not cover WLS. I was in the same boat and decided to go with self-pay and I went to Mexico. I waited 5 yrs and they were not going to change the policy. I am so happy I did. I am not quite 3 months out yet and down 70 lbs. I wish you luck on finding a way to do this. Cathy