Insurance Help

My insurance is pretty clear that it does not cover Obesity issues. Is it possible to  appeal this? Waht is the process? Any advise would be appreciated.

If it is written in the book then chances are you will not be able to get them to cover it. Cash option is the only other way and for RNY with a bmi around 39ish cost 20k at Elmbrook hospital. The higher the bmi the more the surgery cost. I would ask this question on the main board probably get more responces.

Frenchman.........

My surgery did in fact allow me to feel full with much smaller portions.  It is true what you eat will be of major importance.  Eating the same sugary or fatty crap.........in smaller portions.....all day long will result in a lack of results.  The tool is in feeling full with less.  Surgery will not address emotional hunger.  It has addressed my physical inability to feel satisfied with my original stomach.  My new stomach rarely 'feels' true hunger but I am drawn to my old habits & foods just the same and have to decide to turn to the tool rather than my own old autopilot lifestyle for success.

Here are some ideas i found on this website after searching Insurance...
I was going to recommend seeking what other policies are offered during the open enrollment period through your employer....
 

What to do if you have a written exclusion policy

Additional Insurance

If your insurer does not cover bariatric surgery, there are several things you can do. First of all, you could consider getting an additional add-on policy that will cover your surgery. An example is Anthem insurance. Premiums may be very high, but depending upon what plan you are able to get, you could come out ahead overall.

Waiting

Another option is for you to wait for the opportunity to get a better health plan. This might mean waiting until open enrollment at your employer or your spouse's employer, at which point you might upgrade from an HMO to a PPO. Or, it might mean changing employers.

Proceed with the battle

Another option is to proceed with the entire process outlined hereafter as if you didn't have an exclusion policy and simply plan ahead for a fight. You will generate all the same paperwork documenting medical necessity, send in your packet, wait for your denial, and have a well-prepared appeal letter ready to be mailed as soon as you receive your denial. When your appeal is denied, your second appeal is ready to go. Along the way, you may contact attorney general's offices or legal counsel which, together with strong backing from your primary care physician, will give you a shot at approval. Check the insurance directory for people having had surgery approved after a first or second denial.

Cash and financing

A final option (which you can do along the last one) is to simply expect to self-finance your surgery with cash. Bariatric surgery is a life-transforming change affecting the rest of your life. Unless your health is rapidly deteriorating, you might save yourself a great deal of emotional turmoil by taking the time to save up for surgery. Depending upon how much money can be borrowed from other sources, this could take a year or several. Note, though, that financing is available for the procedure. Hospitals and surgeons around the country often offer special cash rates to people without insurance. Through saving, borrowing, and institutional financing, bariatric surgery is as within reach as a $20,000 automobile might be. Insurance might or might not be of help to you. It shouldn't, however, by any means have any final say in what you do with your life.

It looks like I'm covered — what next?

DR PLEATMAN IN MICHIGAN DOES VSG FOR 11000 CASH AND ITS ONLY 6-7 HOUR DRIVE AND THEY DO EVERYTHING THE SAME WEEK AS UR SURGERY SO U ONLY NEED TO GO ONCE AND DAYS INN IS 50 A NIGHT