I give up!!!

Well, I was supposed to have my consultation appointment with my surgeon tomorrow. I just got a call from them saying that they have been in contact with my insurance (Regence BCBS of Utah) and they said it's an exclusion, and they never have nor will be covering WLS. I ROYALLY screwed up my credit in college so there's not a chance I can get a loan. I've tried and been denied. I only have $3000 in my 401K. I do own my house but have only been in it for a year now. I'm a 21 year old wife and mother. I just don't see how these insurance companies can have the power to possible save a life and they turn their back on you. That's asinine. I have a 16 month old son that I can barely keep up with as it is. If anyone knows of any miracles, I'd love to hear of them!

Hello Tell me about it. Those insurance companies don't care, but when you pay your premiums they have their hand stuck out. I'm frustrated too, and if i can't get a loan to self-pay i just give up!! I'm tired of being depressed all the time over some surgery i can't get!! Amber

Dont give up. I have an exclusion in my policy also and even though it does get frustrating i havent given up hope yet. Appeal it again and again if you have to. If your insurance company is self-funded talk to your HR person and see what they can do. I figure if it is meant to be then it will be. Just dont give up hope just yet.

Kate is right, don't give up. FIGHT THEM There was a lady on the phone from my husbands HR and another lady from BCBS of IL. The lady from BCBS of IL told me that my husbands insurance stopped paying for WLS back in 2001. I got my WLS. It was medically necessary. You can't tell someone. I'm sorry but we don't cover so go die quietly. My Doctors said if she don't get this surgery then she'll lose her legs. My PCP was worried because my weight was going up and not down and I was on the border line of becoming a diabetic. Sleep apnea. Get your doctors to back you. Have them write letters on your behalf. Donna

Dear Callie, I am so sorry about your situation. I do know how you feel. This is my story. I started working on WLS in November 2002. I found a doctor I was happy with in Atlanta,Ga. I had a consultation in April,2003. I started with all my workup in June,2003. I spent alot of time and money traveling to and from Atlanta. All of my lab work,etc. checked out. Only my hemoglobin was low. He told me to work with a hemetologist and get my hemeglobin up.I was already approved by BC/BS of SC for my surgery. The hemetologist was opposed to WLS in general. He took 9 months to work me up and get my hemeglobin up to a normal. I found out that starting Jan.1, 2005 BC/BS would not pay for my surgery. They have excluded it from their policy. I pushed the hemetologist, the surgeon and their office so I could get my surgery before 2005. The surgeon's office called me on Dec.23 to inform me that he decided I was too much of a risk after getting a letter from the hemetologist. I had no time to get another surgeon. Now it's 2005 and all the research I have done so far regarding self pay or other options looks very dim. But I am 45 years old. My bmi is 57.7. I work full time and have a family. My health has deteriorated in the past 8 years. I want to feel good. I want to enjoy life not become totally disable. I will keep looking and fighting for my life.Thanks for reading my story. Donna Hudson

Donna, I am in SC also and struggling with current insurance CArolina Care after being denied by BCBS. Dr. John Little, Chief Medical Officer of BCBS is the one to thank for their deciding to deny WLS. I wrote him a personal letter yesterday. Contact me and I'll give you his address and give some other suggestions. Read my reply to Kathy Padget (1/6/05 at 6:24 PM). Jeannie

Callie, Girl, don't you dare give up! I have UHC and they have an exclusion in my policy too. When I first called my doctor to set up an appt. they did the say thing your doctor did, told me that there was an exclusion and they did not know if they could do it. I was like WHAT? YOU DON'T KNOW IF YOU CAN DO IT? There are ways around exclusions. Like the other ladies have posted, call the HR dept. at your work, call the insurance company, call everyday if you have to, talk to anyone and everyone until you get a YES! What are they going to do? Tell you not to call anymore? This is your life and don't you give up on it. Your baby needs a healthy mommy, you would not give up on him if he told you NO! Just think if it was your baby and he needed surgery. If the doctors told you no, you would go to hell and back to get a YES! We can do this together please feel free to email me if you would like to talk about this. I am 25, married, have a 21 month old little boy, 252 pounds and have an exclusion, so I know what you are going through. With us and God you can do anything! Email me at [email protected]! Be blessed and you are loved...your miracle is on the way! Christina