Inurance doesn't cover surgery, don't have the money to pay for it

Eggface
on 5/28/14 9:56 am - Sunny Southern, CA

Don't ever lose hope... keep fighting and more importantly make healthy changes like you are preparing for surgery regardless...

Up protein packed meals, reduce simple carbs, move a little every day, little changes add up :) 

Call or email Walt and at least have a chit chat too... you never know, maybe some more comorbidities documented to make your case. 

The OH rep mentioned wlsfa.org (grants a few surgeries a year) 

Sending good vibes your way!

 

Weight Loss Surgery Friendly Recipes & Rambling
www.theworldaccordingtoeggface.com

Time2StartLiving1107
on 5/29/14 1:22 am - Avondale, AZ

Thank you everyone for all of your help. I will not give up I'll keep looking at all of my opitions and see what happens.

 

Sarahlicious
on 5/29/14 2:36 am - Portsmouth, OH

Take it to the final appeal. Keep at them. Also I have seen a few, very few people go through their state's Vocational Rehabilitation program because the weight affected their ability to work. There was a lot of work on their part to do to get the authorization but I have seen it happen.

I have Lipedema and Lymphedema. I also have a passion for Obesity and Health Insurance Advocacy

Blog: born2lbfat.com Facebook: Born2lbFat Twitter: @born2lbfat

Bmspc
on 5/29/14 2:16 am

I feel for you. My last two plans had zero coverage for weight loss surgery its awful. Don't they realize how much money they would save by treating the problem as opposed to all the co morbidity associated with obesity long term. I ended up taking the money out of my 401K as it is allowed for medical necessity.  I am paying myself back into my 401K monthly as required. 

Time2StartLiving1107
on 5/29/14 2:21 am - Avondale, AZ

Thats the same thing my PCP says, she doesn't understand why if its medically neccessary they won't just cover the surgery.

Aes85
on 5/29/14 2:36 am

try saving money, and with that saved money look into getting your surgery in Mexico.  even with insurance covering surgery, most policies have an out of pocket maximum that would require you to save in order to financial satisfy that before surgery, so saving money is something you will have to do regardless. 

28M, 6'2 ft.  HW: 313.  SW: 280.  CW: 261. RNY 5/21/14.

    

Time2StartLiving1107
on 5/29/14 2:39 am - Avondale, AZ

Thank you very much, I'm hoping one day I'll be able to save money for this surgery. Until I'll keep trying to lose as much weight as i can on my own.

Aes85
on 5/29/14 2:42 am

you're welcome, personally my policy had a $2,500 out of pocket maximum that I had to pay before the surgery took place.  some people have higher or lower maximums.  So just keep that in mind if you are going to look into the insurance route. just so you give yourself some time to save either way.

28M, 6'2 ft.  HW: 313.  SW: 280.  CW: 261. RNY 5/21/14.

    

Billy D.
on 10/17/15 4:05 pm

You live in Arizona, I am surprised your employer does not cover it, they opted into the Obamacare and it should be available , it is for the Medicaid patients. If you have a co-morbidity such as Diabetes, or Heart disease your employers insurance might do it, you would need Dr.'s letter saying that it is a medical necessity. The quicker you start getting the ball rolling the better as they require many tests and class on nutrition etc. Depends on your carrier. But you may go onto the exchange and buy a plan during open enrollment, you probably qualify for subsidies too if you make less than the amount they list. Good luck.

Time2StartLiving1107
on 10/18/15 5:33 pm - Avondale, AZ

When I wrote this I was working for United Healthcare for their employees they had an exclusion on the weight loss surgery so no matter what we were unable to get it covered through insurance even with a written letter from my doctor it was still denied but now I'll have Aetna insurance and it will be covered

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