H E L P !!!

My surgeons office called and said that my insurance company does not cover any type of procedure for obesity. HOWEVER in my benefits book from my insurance it says " We do not cover weight loss procedures/programs UNLESS it is medically necessary. Also- I have seen several profiles of people on this website that had the exact same insurance as I do thats had the surgery approved. What do I do?!?!?

Hi April! Don't give up!!! I would suggest you talk with your surgeon's office about what your policy states and see if they can advocate for you with the insurance company. Maybe you need more documentation to prove medical necessity. Depending on what your surgeon's office will help you with, you may want to call your insurance company and ask them what their criteria is on proving medical necessity. That's what I would do. However, I am a rookie at this as I have also just started on my weight loss surgery journey. Maybe some more experienced folks will also post with some suggestions. Keep fighting, I think you have a good chance at winning if you can prove medical necessity. Let me know if I can be of anymore help and feel free to email me anytime. Keep us posted. Tammy

The key word is "medically necessary" I was told that my husbands company don't cover WLS and that I'm wasting my time. Don't always beleive everything you hear and read as I got my surgery. Call your insurance company and talk to them. Call back and talk to more then one person. You'll sometimes get different stories. I sometimes would call my insurance company two, three times a day and get a different person on the line and get a different story. Also do talk to your surgeon as they might clear it up on the fact that you need this surgery as it's "medically necessary" Donna 338/232 -106