Weight loss surgery

Please please please help me help my daughter. My daughter is 17 years old and has been fighting weight problems ever since she was 2 years old. We finally have convinced her to try Gastric Sleeve surgery. She has agreed and is looking forward to a great life after surgery. I ran into a problem with insurance where they said they will not cover the surgery. I am asking anyone if they might have any answers to who might cover this and what company i have to go thru to get this done who you went thru to cover the cost. I am now ready to cash in my 401 to fund this surgery for her. Thank you all for any help you might provide to me.

It all boils down to what her or your insurance company covers. I am assuming that because she is a minor she is under your insurance. So only your insurance company can tell you what coverage is for bariatric surgery. It may not cover it at all, many do not as it is expensive for the employer to cover so lots of times it isn't a covered item. Also her age may be a factor since she is a minor she can't legally sign a contract or surgery agreement.  Has she seen an endocrinologist to determine if there is a physical reason for her obesity. If there is a physical reason that will need to be addressed and if not then it would usually be from a psychological issue that will also need to be addressed. If this is the case then that can be a big issue and will have to be dealt with because surgery will only reshape the stomach not do anything for the brain. There is a great deal involved with weight loss surgery and very little of it has to do with the actual surgery. All the weight loss surgeries can be eaten around so good surgeons will require a lot of work before the actual surgery. So you have a lot of work to do and think about before you or she ever get to the point of surgery! Good luck and it all still boils down to what SHE wants, 17 is very young to be making this kind of life changing decisions and what ever you do stay away from the lap band it has ruined more lives than any surgery I know of and the damage it causes is life long besides the fact it doesn't work well for most people far older and more able to follow directions than a 17 year old.

Did the insurance company say they don't cover bariatric surgery or did they deny the request? That is a big difference. If they don't cover weight loss surgery you will have to look into other means. If they denied the surgery then there should be a process for appeal. Get a copy of your plan document and read what is covered and their appeal process. My insurance will only cover gastric bypass. No other weight loss surgeries are covered. My original request/submittal was denied and I appealed the decision and asked for a determination for medical necessity. It took a about a year to work through all the paperwork but I am scheduled for RNY next Tuesday. If your insurance company doesn't cover any type of weight loss surgery than look into the different medical credit cards before you cash out your 401K. My doctor's office had a brochure for one with a relatively low interest rate. Take the time to research which surgery would be best for your daughter and consult bariatric surgeons in your area they may have some recommendations if your insurance doesn't cover the surgery. The more information you have the better off you will be and the more in control of the process you will feel. Most of all Don't Give Up!

Dear Caliannie,

When I discussed this with my medical rep, he stated that it is covered but there are several steps that need to be taken before surgery. I know those steps and have provided some of them. The other steps are those that have to be taken thru the Bariatric process. We then made a consultation appointment and when we were in the exam room with the Dietitian the insurance billing lady came barging in and advised us that she called and my carrier stated that they do not cover this type of surgery. I was so unbelievably mad. I had to leave unless I wanted to pay out of pocket $450.00 to finish and talk to the Dr. I started looking up on line insurance coverages. I found a site "www.bariatric-surgery-sourch.com/financing-bariatric-surgery.html" that states "Due to the passage of the affordable care act, insurance companies in 23 states are REQUIRED to cover weight loss surgery for all plans, family plans and small group plans(employers with fewer than 50 full time employees). My state of Iowa is in that 23 state group. I called my rep and he stated that this is from 2014 and it is therefor not covered. I do not understand how this is not covered. My company has under 50 full time employees. my coverage is thru Coventry. I DO NOT RECOMMEND ANYONE GETTING THIS INSURANCE CARRIER. 

A few years back, the gastric sleeve was considered experimental and several insurance companies did not cover it.  But it seems so mainstream now that I can't imagine that's the case.  Perhaps you can go online and figure out exactly what is or isn't covered? Another option is to speak to the coordinator at the surgeons office, the insurance lady.  She could also tell you what your insurance plan covers and what they do not.  There are special rules and requirements for minors under 18 so research carefully. 

I'm not telling you to not be mad - this is your daughter after all, not mine. I know I lost my marbles a few times at my own insurance coverage.  It is so confusing - it's maddening.  But I quickly learned that the surgeons office insurance person is your best ally in this. The surgeons office doesn't make up these rules, and they get frustrated with them too. They want your daughter to be covered; if she is a good candidate they do want to help. And the insurance person will help you get coverage or make payment arrangements. In my case, I had to both get myself up to speed on the process and the requirements, and then I took a deep breath... And listened to the coordinator (the insurance lady).  I did every thing she asked.  Jumped through every hoop.  She became my partner. And everything worked out for me.  I hope it works out for your daughter, too. 

Dear Hislady,

Thank you so very much for your comments. I do not want everybody to think this decision was mine. My daughter is the one who selected this procedure. We have seen an endocronologist and he was able to speak to her with my presence. I love my daughter to the moon and back no mater what she weighs. I just want to do what she feels she wants to do. She is a very strong woman and very responsible. I think she does realize that this is a very big step in her life and has told me multiple times that she will do anything to get this weight off. She has a BMI of 48 right now. The surgen stated that this procedure is not done on anyone with a BMI under 35. I do want to thank you so very much for communicating with me. Any comments given are taken to heart and will also be shown to my daughter for her to see as well. Life has to go on and I just want her to live a full and happy life without ridicule. 

They have some top notch facilities in Mexico from what I have read and are priced very economically. Many people on these boards have gone that route. Here is a link to a forum where you can ask more questions. http://www.obesityhelp.com/forums/mexico/

 Okay if you have the money you could look into this procedure which helps you not feel hungry all the time. 

I can't remember what it's called but the doctor puts a balloon into your stomach which is then filled with saline (sal****er). This makes the stomach feel full and you lose weight. They take it out after six months or so. 

The reason I recommend this is because I would have it done in a heartbeat if I had the money. It has no cutting, they put the balloon in by going down your throat. It is safe, even if the balloon broke you just pee out the sal****er. It is completely removable. 

What worries me about other surgeries is that the results don't last, they cause masses of pain and may make your life a living hell. Really think about this course of action and try to find a pain reduced way of going about it. 

I wont tell you to go on a diet, at 200 kilos I hear it all the time and I know it wont mean much because I ignore people too. I know how bad it feels to be overweight and I hope you find an answer which works for you. 

All the best :)

David,

Thank you so very much for your response. We are now looking at all options. It is so great to have other people like your self that is so caring to try to help her out. We will weigh all options as you stated and hope to get the help she needs.

Thank you for caring