Jean, hoping to have surgery

I started this process last year. I had some family issues & put possible surgery (bypass) on hold. Since then the my husband's company has renewed the insurance. I went to see my new doctor on Wed. 5/14/03 & they just needed a couple of things to send off to the insurance company(BCBC PPO/Carefirst). I called to ask BCBS some questions & they advised that my husband's company had a Self-Insurred plan through them that they were just administrators & the company had excluded any surgery or treatment of obesity or morbid obesity. They also said any requests put in would be issued a flat denial. My friend told me to go ahead get my paperwork together & put it in anyway. I'm not sure what to do. Can they do that? Even if my PCP deemed if medically needed! I can't even describe how the whole thing makes me feels. I have a BMI of 52, no major helth issues except I'm in pain & out of breath if I walk more than 10ft & can't even keep my house very clean anymore. Why should I have to wait until I have a heart attack? Sorry for rambling

Yes, if a group is self insured THEY MAKE ALL THE RULES and can exclude anything they want. You will have to go to the group administrator to have them give the insurance a waive to approval your surgery. FIGHT IT !! TRY everything possible !!!