Insurance info. WEA?, Physician's Plus? Secondary insurance?

Kathy B.
on 6/17/05 2:33 am - madison, WI
Hello! Our insurance said they do not cover gastric bypass (WEA). My husband may be able to pick up Physician's Plus. Does anyone know if they cover it? Has anyone heard of a secondary insurance that can be purchased if you already have a primary insurance and then the secondary insurance would pay for WLS? Has anyone been successful in fighting to have insurance cover the surgery when they have said "no"? Thank you! Kathy B.
Jen
on 6/19/05 3:47 am - Southern, WI
Hi Kathy, I have Dean Health Plan and its a written exclusion except if you are federal employee (and with WEA I'm guessing you are not). I fought it hard, had a personal teleconference with the president of dean, and was still rejected. The costs of my drugs on an annual basis cost as much as my surgery. And costs for my co-morbidities were around 100K over the past 4 years. I was devastated after I was rejected and decided it was less painful to pursue options for payment. My accountant informed me my medical costs for this year are tax deductible, so I will get part of the cost back. I have a good relationship with my personal banker and she let us borrow home equity. I had a lap band. I have a sneaking suspoicion that RNYs are more easily approved for medical necessity. 5 days out I feel great about mydecision and have no regrets. I took a 20 min walk this morning and lost 20 pounds pre-op on the liquid diet. Good luck with your journey! Yours in pounds down, Jen 425/405/395 mini-goal PS: Do you think I could invoice dean for the cost of the medications I don't have to take now that I've had the surgery? It sure would offset my costs LOL
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