kinda dissapointed

Hey y'all... im fairly new to this forum and I was stoked when I found it I am a 29 yr old who has been overweight her entire life. Im 5'9 and almost 300 lbs... I recently spoke with my doc about the Lapband and she thought I would be a great candidate for the procedure. I have tried every thing under the sun to try to lose the weight on my own.... always failing miserably...so this is where the dissapointment comes in... I called my insurance office to find out if my plan covers anything to do with the procedure... just got the call back with the answer of No... not covered at all... I know many of us are in this situation, but it just hits me hard bc I was convinced this was going to happen and would be a great tool to help me actually lose the weight and keep it off... I can't afford to pay out of pocket for it... I guess what I really wanna know is how any of y'all did it? I make little to no money and what I do make goes towards bills... sorry for the rant but I needed someone to tell all of this to. Thank you for listening.
~Melissa~

Try asking your GP to write a letter to the insurance.  She knows how you have struggled with your weight, and she could be an advocate for you.  Good luck.

Do they cover any other type of WLS surgery if they do I would look into it...most insurance cover RNY.. mine covers both but very little $5K I had to pay the rest out of pocket so one of the reasons I choose band was cost. (one of the reasons) but if they cover RNY I would consider it...

Good Luck

If there is an exclusion in your policy for bariatric surgery, it is no.  There is one person who says their insurance put in an "inclusion" just for her but then she disappeared.  I personally thought she was telling a little white lie.

At 5'9 and 300lbs, I bet you are still beautiful Melissa.  Could you join WW in the meanwhile?  They have a great program now.  You won't leave empty handed because you will get to know good nutrition.  You are young enough to wait a bit.  I am sure that you will position yourself to become equipped with insurance that will include bariatrics in the future.

Blessings,
Leila

If your policy does not cover Bariatric Surgery -- even an appeal will not help.

Simply put, your company or yourself does not pay for that benefit, and so it won't be covered.

You can do a few things --
1.  ask your doctor to write an appeal (to at least get it in the files)
2.  talk with your HR department or whoever purchses the insurance plan you have, and ask if there are options for next year's coverage -- and how you can change to a covered plan
3.  get a part-time job at a company that covers WLS (I believe that Starbuck's and Home Depot offer health insurance to part timer's and they cover WLS)

I self paid for my band.
 
I LOVE my band and my results, but if I had to do it again, I would not self pay for a band, I would go for the VSG --- band is time and money consumptive and has the most risk for follow-up surgery.  If you self-paid once, you will have to self-pay for all follow up.

The Home Depot does offer PT insurance but it will not cover bariatric surgery.

Getting that denial is SO disheartening, I cried for hours when I got mine.  But my parents offered to give me the money so that's how I paid for it.  There are companies who loan money specifically for health care.  I think it's like a credit card.  Or you could talk to your surgery center and see if they offer any financing options.

My policy specifically excluded all bariatric surgeries so an appeal was a waste of time but I did have my GP and my RE both send letters just to have them on file.  If self paying is absolutely not an option, then I think that the Starbucks part-time gig is an EXCELLENT idea.  Good luck!  And don't give up!!