I don't know what to do

G. Morales
on 9/10/15 11:37 pm

Hello everyone,  I am Gem and I am desperate about my weight, I don't even want to see my self in a mirror any more..I want to do the gastric bypass but my insurance don't cover, bc i am not sick .It is very expensive , i cant afford it. I don't wanna live like this. 

There must be any insurance I can buy that can cover the surgery 

If you know pls let me know. 

Sincerely 

 

Gem

Cicerogirl, The PhD
Version

on 9/11/15 7:15 am - OH

What "sickness" does your insurance require?  Have you looked at the actual policy declaration in it?  Most insurance policies that cover RNY have a couple of different ways you can be eligible: either have a certain amount of excess weight (often a BMI I of 35)  AND have some weight related illness (there are many of them that qualify) OR just have a larger amount of excess weight (often a BMI of 40). 

If they cover it for the first condition, they very likely also cover it for the second.  What is your BMI? (You can calculate it at this link)mPlease get a copy of the actual requirements if you have not already, because you may very well qualify after all.

Depending on what state you are in, some of the Obamacare related insurance plans offer it (some states require that it be included) but in most states they don't. Unfortunately, individual plans (as opposed to hroup plans) don't usually cover weight loss surgery because it increases the premiums so much and is too expensive for most people.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

G. Morales
on 9/11/15 3:11 pm

Thank you very much Lora ,  I have a bmi of 35 and I am In Florida,  in order the insurance can pay the surgery , I have to be diabetic,  sleep apnea,  etc.. but I don't have any illness. 

 

Gem

 

ave 

Cicerogirl, The PhD
Version

on 9/11/15 5:10 pm - OH

Do you have pain in your joints that may be arthritis?

Has your blood sugar going up each year?  Even if you are not yet diabetic, many insurance companies will count it the same as being diabetic if you can show that your blood sugar has been going up steadily for several years (because it is only a matter time before you will be diabetic).

Are you SURE you don't have sleep apnea (do you snore loudly)? Many people who are obese have a mild case that has just not been diagnosed.

Have you had bronchitis or some other type of significant respiratory illness every winter (that can be worsened by the lungs not being able to keep up with the physical demands of an obese body)?

ANY significant medical issue that can be caused or exacerbated by obesity can be included in your request for insurance approval. Not just the "big two". If you have a number of small ones, they might still approve you.

Lora

 

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

MsBatt
on 9/11/15 7:08 pm

Other co-morbs include things like GERD/acid reflux, PCOS, insulin resistance, asthma, high blood pressure, a few others I can't think of right now. (A bad memory isn't one, I'm pretty sure. *grin*)

MickeyDee
on 9/11/15 11:04 am

Please read your insurance policy carefully;  mine said "no weight loss programs", but that meant no coverage for Weigh****chers or Jenny Craig style programs.

WLS was covered for me because it came under the "medical procedure" coverage.  Check out your BMI on the charts available, and then talk to your PCP.  I was a candidate and covered because of very high BMI, Diabetes II, high blood pressure, and osteoarthritis in my knees.  (I was a physical wreck!)  

Don't give up.  If you can't get surgery in the USA because of the expense, consider WLS in Mexico, where I've seen very favorable reviews of surgeons and facilities on this website's "Providers" menu, above and to the right.

Good luck.

SkinnyScientist
on 9/11/15 1:36 pm

Can you change your insurance to one that does cover wls in open season?

RNY Surgery: 12/31/2013; 

Current weight (2/27/2015) 139lbs, ~14% body fat

Three pounds below Goal!!! Yay !  

Jessicaellison74
on 9/12/15 2:12 am - Lutherville, MD

Do you qualify for Medicaid if you do your state might cover it

Sharon SW-267
GW-165 CW-167 S.

on 9/12/15 7:32 am - PA
RNY on 12/22/14

I'm not sure where you are at in the process.  You do not state what your weight, age, or general health.  Have you gone to a doctor's public information meetings?  Who said you could not get it covered?  Why are you so desperate about your weight?  What have you tried?

I would suggest seeing Dr. Matthew Weiner's video.  He does both surgery and non-surgical weight loss and has a good handle on the changes needed for either.

http://drmatthewweiner.com/

The second tab from the left says VIDEOS.  The two tabs that drop down are for Non-surgery(A pound of Cure) and the other is for surgery.  Click a tab and about 10 videos for each will show up.  Please look at a few.  They may give you a valuable perspective on your situation.

Sharon

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