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Sorry for replying late! I have not been on in awhile. I ended up calling and they said WLS is excluded from my plan. I feel as if I have hit every possible dead end.
Thank you for the information!
"BMI over 40 OR 5 years documentation AND 21 years of age or older."
I truly hope that is the case. It seems to me since I had to call my HR dept to get the website and then log onto it with my social, that this is what my pre-requirements would be. It also states in the beginning of the literature that if there are any other that this one would over rule.
Laurie
Sleeved 6/12/13 - 100 pounds lost to get to goal!
http://www.obesitycoverage.com/insurance-and-costs/am-i-covered/check-my-insurance/item/kaiser-permanente-weight-loss-surgery-criteria
Mz. Scarlett.... I agree with almost everything you said, except for the fact the part about the insurance having nothing to do with weight loss surgery being a written exclusion but rather an employer issue. I have been battling with my insurance for EIGHT YEARS NOW!! My employer is onboard and has done EVERYTHING possible to try to have coverage for WLS included in our policy. In battling this, we have been told our insurance company does indeed have a package for bariatric surgery/treatment that is available at an extra cost. However, it is available only to employers with 50+ employees. There is nothing in place for those small employers, like single physician offices, etc. We have tried every route possible to try to get this over-turned with no luck. If you have information that would help me force this insurance company to provide the same options at a cost for us, I would definitely love to hear from you. With that being said....I too am hoping and praying for the single-payer program in Oregon!
Sometimes i think the whole insurance aspect is the hardest part when starting on a WLS journey.
Well I called my Human Resources, they gave me a website that I have to log onto with my social and whatnot. Under that I can see all the specifics that my company has issued through UHC. All it says under Obseity Surgery is that you must have a BMI over 40 OR have five years of documented weight being obese and be 21 years of age.
So that should be the final on that, right?
And since it says either or then I should be approved. And it also never states anywhere that I must complete a six month weight loss trial.
I'm buying an individual plan just for a few months to cover the surgery. Has anyone else done this? A little nervous about it, since I don't want to throw thousands of dollars away if I won't get approved, though I've heard that its easier to get approved on individual (non-group) plans since you're paying more.
Just nervous about the whole thing. Getting so big that moving around and taking care of myself is difficult, which it shouldn't be at only 33 years old. :(
Laurie
Hockeymom87 · 0 replies · 688 views
