GOOD JOB---Insurance SUCKS

bigwhite
on 7/4/07 7:44 am - Kutztown, PA
I am stuck in the situation where I have a good job that I don't what to leave  but the medical ..insurance will not cover the surgery.  I don't know what to do.  I am 26 371 lbs.  I am 6 foot 3 inches.  My primary doctor has been concerned about my weight for years.  I have many co-morbidities along with now me going to see an orthopedic surgeon telling me that I have the start of arthritis in both knees and then only way to alleviate pain is to lose the weight.  I am stuck and frustrated by my situation.
.::Princess
Nutmeg::.

on 7/4/07 11:16 am - Rohnert Park, CA
Is there any way you can self pay? Dr. Alvarez does the VSG for about $10,000 travel included. Other surgeons in the US do it for about $11-$12,000. I'm not sure which surgery you wanted...but maybe you can get a loan to pay. OR appeal the insurance decision on the basis of it alleviating dangerous conditions in the future. I hope you get your surgery. I'm frustrated by my insurance right now too.  
(Hi/DoS/CW/GW) 335/320/243.5/174  (-91.5)(total lost) in 18-20 dependent on brand!
I'm more than half-way there! :) (68.5 pounds to go)
Pam T.
on 7/5/07 3:33 am - Saginaw, MI
Have you talked to your employer about the exclusion in the insurance?  A simple conversation with the HR department might make them aware of this exclusion and get them to add it to the policy with the next renewal.  Are there others in the company who have expressed an interest in having the surgery as well?  Two voices are better than one and three is even better.   Might be worth a shot. Pam

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gary viscio
on 7/5/07 4:37 am - Oceanside, NY
RNY on 07/01/03 with
All good suggestions.  You have the right to appeal the denial, but your success depends upon your state, and the type of plan. The easiest thing is to speak with your employer just like they said and try to get them to add or change the policy.
Gary Viscio
www.ObesityLawyers.Com
RNY 7/1/03  -166lbs
(deactivated member)
on 7/5/07 9:49 pm
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