WI state employees needed

Jody, And this is the WPS--State Standard Plan? They did not require me to take Orlistat. But they did want proof of a dr.'s supervised diet for 6 months.

Ricki, Yes, this is the state standard plan through WPS. The actual denial I got was before I switched to the State Standard Plan, and I am still in the process of trying to get an approval from WPS. I just happened to notice in the benefits booklet that I got recently, there was this added restriction. I am still going to go forward, as I have been on Metformin for three years now, and I am going to see if they will accept that in place of Orlistat. The ironic thing about this whole situation is that about 4 months ago, I took at thrid job to try to pay for this surgery. Besides my full-time job for the state, I also work part-time at a halfway house, and the third job is part-time at...WPS! I started there before I realized that they would be taking over the state contract, but even so, I only deal with retired military beneficiaries, so I don't have anything to do with the state coverage. The other ironic thing is, if WPS approves me for the surgery, I will have to take time off from working there during recovery. I don't know if there is any type of cross-checking for that, and I hope that doesn't affect my approval.

Jody, What doctor are you going thru? (may I ask?) I have the UW Bariatric in Madison, and they were very helpful in providing WPS with everything they needed to review my claim. Which insurance company required Orlistat? Was that one of the HMO's? For State employees they all have written exclusion in the plans (the Uniform Benefits). With the Standard Plan you have a much better chance at approval if you can figure out all of their rules.

I originally went to Barix Clinics in Belvidere, IL. I am now scheduled for a WLS seminar on April 10th here in Madison (Drs. Garren and/or Gould I believe).

I also switched to the standard plan as of January 1st. The hoops you need to jump through are absolutely ridiculous. I would like to think that paying upwards of $600.00 per month out of pocket for insurance would get you some kind of break. We work for the state and pay these astronomical premiums and deductible to boot, but if we were unemployed would much more easily be able to get this life saving procedure. Since when did working for the state allow them to play God for you? I will continue my fight if it kills me.

I am a state employee who had to take the most expensive insurance coverage of $250.00 per month in order to possibly be approved for the surgery. I was denied recently and they want me to go through some sort of physician supervised weight loss program, before possibly approving. I personally know of two employees within my office who tried to get it with the other insurance plans and were denied outright. Karen Mosley 4142274426