Anyone had WPS cover WLS??

Hello, WPS has begun the process of making me jump through hoops for surgery. I went from depressed to angry. They SHOULD pay for this! I have only heard of one person on OH who had an RNY through WPS. I am looking for anyone who has WPS. What kind of surgery did you have? Did you try for or consider a lap band? I will also post on the insurance page and the Lap Band page. But I think WPS is only in Wisconsin, so I was hoping for some feedback here. Thanks!! Donna C

Hello, I also have WPS of Wisconsin I talked to them prior to my appointment with the surgeon and they gave me all the info I need for the Dr as to what medically necessary means to them, So far so good I guess. I have sent in my paper work and now have to wait .They have only 15 days to respond. Hope this helps you some. Bettie Jo

I just recently had my surgery on October 14th. My insurance company was WPS and had it covered without any problems. I believe its dependant on what your company chose for inclusions and exclusions in their policy plan. If they have exclusion but will cover for medical necessity, just be sure to call and ask specifically what they will need from you to cover the surgery. Hoops though a PITA are usually easily overcome. If you don't have a direct exclusion regardless of Medically Necessity, be happy you only have hoops to go through! With persistance you will be covered. HTH! Debby

hello Donna I just had surgery this past Wed. and I have WPS. I Had wanted to get the Lap Band but they denied it stating that it was experimental. However they did cover VBG with no problems. Good luck to you, Keep me posted. I would like to hear if they covered it for you. I know that this is such a stressful time. Tammy

Tammy, Congratulations on your surgery. I hope you are doing well. I don't really know much about VBG, and didn't know there were any doctors in Wisconsin that did it. Did you try to appeal WPS, or decide VBG would be better anyway? I will let you know how mine turns out. I changed surgeons, and my new surgeon is able to get all my pre-op evals in much quicker, so I may still make the 45 day deadline. If not, I will have to start all over. It helps to know WPS told you it was experimental, because I will tell my surgeon to include data in the original application showing it's not. Good luck on your healing, and congrats on being on the losing side!!! Donna C

Donna, I did not try to appeal as my doctor's office already told me before they sent my info to the ins. that they have never had a patient that was approved for lap band that was covered through WPS. I was so nervous because I thought that they would decline all surgeries. My First choice was lap band, then VBG. I was not comfortable With RNY so If they would have delined lap and VBG I would have appealed but I got the okay just 2 weeks later. I am very happy with my decision and I wish you the best as well. Tammy