Medical Neccessity?

I was just wondering if anyone out there could help me with this. I have had three back surgerys in a 10 month span. I think this last surgery took pretty well. I have been over weight my entire adult life. Yo-Yoed up and down. Was able to excersize ok before my back problems but since the back problems my weight has ballooned. The weight is creating more back pain. So now the pain is being managed with meds. I dont want to depend on meds my entire life. I know if my weight was down my pain would be gone. Do you think they would consider this a neccessity? My primary doctor aggrees and has stated so in a letter. Thanks Linda

I do not know anything for sure but, it sounds like it would not be a medical necessity. If you could not have the 3 surgeries due to your weight and had to have the WLS in order to have the back surgery , that would probably be a medical necessity but, you have already done the surgeries and the pain is managed with drugs so, I don't think so.

If the weight is such a strain on your back that it is making recovery impossible, perhaps they could prove it. You need to talk to your PCP. Rose

Linda, You would be surprised what insurance companies find as "Medically Neccessary". I suggest seeing your family doctor and from there if he/she finds it medically neccessary to refer you to a surgeon, they will do so. Good luck to you! Shawna