Feeling Forced to Finance

 Hello All!

I'm new to the forums as I have been viewing the site for a bit now.  I've just started the weight loss surgery process and had my first consultation today.  I've been so excited!  However, for some reason, I've been feeling like I was not going to be able to take the next steps due to insurance.  Lo and behold I got a call a while ago from the surgery office saying that Aetna has no provision in my plan to provide for any surgery.  

I feel like there was no explanation other than "they won't do it" and now am feeling forced to look into financing options.

Has anyone else dealt with this?    I am so blindsided that I'm unsure of my next step when I know this is something I need to keep looking towards doing.

Any input would be greatly appreciated!

Hi,

I have Aetna and myself and my three kids all have had surgery.  Aetna approved and covered eachof our surgeries.  Aetna does cover WLS, it must be that your employer has an exclustion to their policy to not cover it.  I would talk with someone in your HR department and see if there is any chance of  them changing the exclusion. 

Good Luck to you!
Nan

 Hi Nan!

You are completely correct.  After posting this, I got BACK on the phone with the surgeon's office got more info and then marched down the the HR department at work.  Someone is now looking into a personal appeals option for me as my employer specifically excluded WLS from our plan.

I'm so certain that this is something I need to do that I'm willing to bite the bullet IF a personal loan is necessary but I'm not going down without a fight and am going straight to the top!  

Thanks so much for the response! :)

- Amanda

Good Luck to you!!!!

I was self-employed when I had my surgery.  I can't say how things work now, but I got some info off this site about 8 years ago.  Every insurance company has an open enrollment month when they pretty much have to take patients they normally wouldn't.  I asked the person in the surgeons office that takes care of these things which insurance company I had the best chance with and they told me anthym blue cross, blue shield.  I called them and got the information I needed to get approved.  Then when It was time for their open enrollment, I sent the money and application.  I had to pay over $700 per month and pay ahead  but I was approved the first time the surgeon sent in the request.  I didn't really have much in the way of co-morbities.  My surgeon told me that it's all in the way you write the letter.  I didn't see the letter, so I don't know what he said.  but it was worth the money it cost.  I couldn't get any insurance any other way, I tried.  No one would take me.
Theresa