listed exclusion

if my insurance onpoint bcbs has a listed exclusion is even worth fighting?also insurance denied but for a totally different reason.(psych eval) .would the exclusion override that denial? thanks for any help..sue

Hi Sue, I also have BCBS with an exclusion for anything weight related.  I fought them through three denials.  They won't even consider it.  I even tryed the it would be a cost benfit to them to pay for the surgery instead of treating the co-morbids.  I also fought Foris for two years with the same exclusion.  I am now trying Texas Rehab.  Anyway my advice is to keep trying.  Try until you can't try no more.  You really have nothing to lose if you don't get the surgery you know nothings going to change for you. I can assume that you have already dieted yourself  to where you are now.  I know I have and unless we have medical intervention we are going to become disabled or die.   I think that the more people who don't give up the more likely that the insurance companies will be forced to stop discrimating against the obese and pay for this life saving procedure.  Good luck to you,  I will keep you in my prayers. Lori

Hi Sue, I have BCBS (Health Select) in Texas. They denied me on the spot and my surgeon's office made me feel like there was no way of getting around it because of exclusions. One of my co-workers who has had the surgery told me to try out Texas Rehab. I don't know if that's what their called now. But, I work for a state university and I'm going to try their Vocational Rehabilitation services. She said that they have paid for some folks surgery. Here is their website: http://www.dars.state.tx.us/drs/index.shtml I'm hoping to set up an appointment with them next week. I'll let you know how it goes (let's cross our fingers!) Let me know how things go for you! I wish you the best! This is such a frustrating process. I don't know why they have to make it so difficult.  Take care, Courtney

Hi Courtney, Sorry to hear your insurance plan will not cover the surgery, Mine wont either. I am through UHC. If goverment they would pay.  I work at a daycare and this lady that had a child in the daycare works at the Vocational Rehab and she was telling me that they will try to help a person work. We filled out a application and I received a letter from them stating I should get a appointment. I did not know they pay for gastric bypass. I am in a big mess. I need a total hip replacement and cant have it until I loose weight. I need to  loose over 100 lbs, and 70 to have the hip surgery. I am walking with a crutch. I am in so much pain. I am at  my wits end. It would be wonderful if they would pay for that bypass surgery. So I need to losse weight, then have hip surgery and hopefully I can stay working. Thats what the rehab place is for to keep a person employed or find them a job. I think it would be worth checking into. Hope to hear from you and hope you can get the surgery covered.  Monica