Walmart BCBS WLS Exclusion / Other Options?

Hello, just a little background info on me first.

I am 23, female. 5'9", 360lbs. Size 22/24. BMI of 53.X. 

I have gained 180lbs in the past 8 years. I've had thyroid testing twice, that's not the problem. 

I tried gym/home dieting from 2005-2006. I've tried medically assisted weight loss 3 times with one facility between 2006-2007. I tried Medi-Fast in 2007. I tried Metabolic Research Center for 4 months in 2008. I talked to a psychologist re: emotional eating for 6 months in 2008. I tried hypnosis in 2009. I then tried medically-assisted weight loss in 2009 for a few months again. I also tried the HCG fad in 2010. I then got a dietitian in 2010. I've lost, at a most, 15lbs, but put it all back on and then some. I've been on prescription drugs for anxiety/depression due to this personal failure since 2005.

I don't have diabetes, high blood pressure, high cholesterol. I do have depression, anxiety, skin problems, and underwent a sleep study and was diagnosed with sleep apnea this year. I sleep with a CPAP machine. I do it faithfully as I know without it, I will fall asleep throughout the day. But because of my extremely sensitive skin, I have switched facial masks 3 times, but I am getting horrible skin reactions on my face from it. I have put fabric barriers over the plastic pieces to stop irritating my skin, but my skin is still irritated and I've had to purchase very expensive creams for my skin to relieve the irritations as they are the only things that work.

My gynecologist referred me to a bariatric surgeon two weeks ago. I went to a seminar that outlines the obesity information, types of surgeries performed, etc. 

It all sounds great. I'd like to proceed with a RNY Gastric Bypass. However, my insurance is with BCBS Arkansas Advantage and it specifically excludes any type of weight loss treatment, surgery, medication, etc. for obesity and morbid obesity.

My insurance company is so ridiculous that when I went to the doctor for my depression, when the doctor had put one of my diagnosis as "obesity" (which he always does?); the insurance company denied the bill. Citing they do not cover charges relating to obesity. I wrote a letter back informing them that 33% of people in my state are obese and if every one of their bills was denied simply for the fact they were overweight, then they should be informed of such when they were accepted as a member and their money should be refunded. They paid the bill.

So, therein lies the problem.

1. My insurance doesn't cover the surgery.

2. I applied for a loan through CareCredit to self-pay for the SX ($18,500 inclusive of surgeon/anes/asst. surgeon/pathology/OP facility). I was denied. (Probably because I have two car loans.)

3. I don't have a house to refinance to get extra money?

4. What can I do now? What are my options?

 

Thanks.  :)

Hello. I as curious if you ever got approval from wal mart insurance? My husband is with wal mart and i am looking to have gastric sleeve, just wanted to know if this is worth persuing or should i seek other financial ways. Thanks you

Maybe do what I did. Go to Mexico. Smaller loans are easier to get than larger loans.

The problem with your ins is that you likely have a plan through your employer. If they do not pay an additional premium for WLS, it isn't going to be covered. Perhaps go to your employer and ask them to add this? Don't bank on it happening because it's expensive and they can't just get you covered, it would be the entire company.