I need some help, Not sure what to do ????

I saw a surgeon this past summer to have the RNY surgery, I was a great candidate, met the criteria, and was ready for insurance approval. Well you can guess, I received a letter from the clinic stating my insurace declined the surgery. I e-mailed my insurance company who said my policy plan does not allow for any coverage related to obesity. Needless to say I was devistated, It was so hard to take the first steps only to get shot down. Im 32 year old man with 3 children and a wonderful wife and a Paramedic by trade wich is getting harder to do all the time since my BSI is abot 60. What do I do now, Do I have any other recourse with my Insurance? Can my employer do anything for me? I could really use some guidence. I sit here night after night flipping through "before & After" pics of others and I want this so bad, I dont know what its like not to be over weight. I would appreciate any assistance I could get with this mater. I live in Wisconsin and have SISCO insurance. Thank you my friends! Kevin

Hi Kevin, I know that the SISCO insurances have a whole bunch of different companies they work thru. My husband has SISCO and it took about a year for me to get through all the paperwork, red tape and bull sh** from them, but I was FINALLY given the go ahead. I will be having surgery Nov. 26th, if nothing happens between then and now! Get out your handbook and go through it front to back. My husband works for Weather Shield up here and has had SISCO for years, but the company is switching to Wausau Benefit Jan. 1 and I don't have any idea how that company is going to be. Back to SISCO, in our handbook there was the whole list of things that had to be wrong, also, before agreeing to surgery. The co-morbidities, the proof of dieting, etc., and they are picky! I had to keep calling and calling the company rep. and get advise, even tho she didn't want to really help, she ended up being pretty supportive. Anyway, look over that book in the surgery section and see what you can find. Good luck. Janice

tHANK yOU

Have you done the appeal letter yet? Maybe try that. I have United Health as of the 1st of the yr so I am going to do all of that through them. Terri