Please Help me..

I was schedule for 1st appt with the doctor on March 11th until I received a call from his office stating my insurance doesn't cover it. Its not under our insurance.. which is through his EMPLOYER..  It is a medical necessity and have letters or recommendations from all of my doctor. What can I do? 

That is one of the first things anyone needs to do is find out if it is covered by their insurance. If they have a bariatric exclusion there really isn't much you can do. Once in awhile I hear of people trying to talk to human resources t see if they will cover it on an individual basis as an exception. For the most part tho if it is an exclusion there is little you can do even if it is put out there as a medical necessity. Just because it is necessary doesn't mean they have to cover it. They are in business to save money.

Get in touch with your insurance company-- call the phone number on the back of the ID card. Verify with them if it's covered, as many insurance plans don't pay for WLS at all, but if there's a blanket exclusion there's likely not much you can do.

Sorry to hear this .... I am from Canada so I don't have any advice on your insurance but wanted to throw out the idea of self pay.  I went to Mexico in Jan of this year as my BMI was just at our approval but I didn't want to wait a year or so ...  I am 100 percent happy with my decision.  I paid 5900.00 

hope this helps!

Janet

sounds like there is an exclusion onthe policy. This means his employer didn't buy Wls coverage for their employees. Insurance companies aren't going to pay for procedures that have not had coverage bought for them. 

All you can do is self pay,take a loan from your home equity or 401k or get a part time job and save up.

What about purchasing another insurance? Any suggestions on that?

I would also recommend surgical tourism. It is much cheaper in Mexico and if you do your research you can find very nice facilities with highly skilled surgeons.

I'm in the process of trying for insurance approval in the US but if I cant get approved, I fully intend to go to mexico and honestly after all of my copays and deductible. It will be about the same price.

I had to switch from my employers insurance who opted out of covering this surgery (which i think is completely unthinkable and should be banned how should an employer decide which surgeries you need?) but I got private insurance and pay 2x's as much.  it sucks but at least i had my surgery covered by insurance rather than paying $15k for it!

Go through Obamacare.  I chose Health Net Platinum and I love it.  I like HMO's personally.  I pay $480/month for myself and my child.  It's very expensive!  I wish i could have kept my daughter insured by employer but it doesnt work like that.  I plan on switching back to my employer insurance at the end of this year.  

What type of private insurance did you get?