HELP ME [email protected]

 I'M 22 YRS OLD I WEIGHT 407 POUND I WORK AROUND THE CLOCK I GO TO THE GYM I EAT PRETTY GOOD FOR THE MOST PART I'M FOLLOWING A DIET THAT WAS GIVING TO ME BY KINGLEY HEALTH BUT ANY WAY MY INSURANCE HAS EXCLUSION ON IT FOR I HAVE SEEN 3 DOCTORS ONE DOCTOR IS TELLING ME HE WILL GET IT COVERED BUT THE INSURANCE IS TELLING ME NO I HAVE BLUE CROSS BLUE SHIELD  THAT IS THROUGH MY JOB WHAT CAN I DO BY THE WAY I DO-NT HAVE THE MONEY TO PAY FOR IT I COULD ALWAYS GO OUT OF THE US I JUST WANT TO HAVE THIS SURGERY , I HAVE ULCERS ON MY LEG MY LIVER IS HUGE AND I'M PER DIABETIC  PLS FILL FREE TO EMAIL ME 

In case you don't know, using all caps is the equivalent of shouting.  It also makes your post difficult to read.  In addition, you really should remove your email address - not a good idea to post something like that, especially in the title of the thread.

What is it that you are asking for?

 sorry didn't mean anything by it i dont mind my email being up but thanks 

Ebony,  You've been a member a long time...  What help are you looking for?  BC/BS has many different policies....  is it possible your employer has a 'no weight loss surgery' exclusion?  You would need to read the entire policy, usually available through your human resource department, and see what it says.  Which surgery do you want to have?  You do know there are many kinds, right?    With leg ulcers, an enlarged liver, and 400+pounds, you would probably meet the 'need' criteria.  You just have to investigate the policy you have.
     Write more, and be specific about what help you are seeking, and I'm sure people will chime in with suggestions.  In the meantime, can you see a wound specialist and get working on healing the leg ulcers?  That has got to be covered under BC/BS.  Good Luck,  Mary C

thanks you so much i have a doc who is trying to fight the insurance now  but the insurance is  through my job and they have a block on it,, so i put the post up to see if any one knew of any other ways to go about it. i have blue cross blue shield  by the way. thanks again

No worries about the caps!  If your employer has a WLS exclusion clause in your policy, there is really not a whole lot you can do to get WLS approved.  I would imagine your doctor's office has a dedicated person (or people) who work with insurance exclusively.  

You could always pay for it yourself (I know not the answer you were looking for).

At least go to get those wounds cleared up - having untreated ulcerations can't be good for you.  And, have everything documented - you never know - it may come in handy!

Your best for "getting around" the exclusion is to speak with someone in the HR dept for your employer.  There are many, MANY different policy options within BC/BS, and employers pick and choose which coverage they want - or don't want - to pay for.

Perhaps if you speak with someone in HR, you can convince them to remove the exclusion.  If you don't ask, you will never know.

It's higly impobable, however, that a doctor/surgeon would be able to get around such an exclusion.

~wendy

Ebony,

Your company may have put an exclusion on your policy. If that's the case, you may want to go to your HR and see if they will do a "waiver" for YOU. Some companies make exceptions for certain employees.

If that doesn't work, I have a flyer for a person who works at an insurance company that deals with Bariatric surgery. Now, I doubt they can get YOUR insurance to pay, but you may have to get "special" insurance from them to get your operation covered.

Finally - while I know expensive, you may want to pay out of pocket and make a payment plan to both the hospital and Doctor. Sure $25,000.00 is a lot of money - but isn't your life worth it? Even if it takes you 25 years to pay it off, wouldn't it be worth it - and be more rewarding ?!?!?

 HI TOM I THINK WE HAVE MET BEFORE AT DR. BERTHA OFFICE 

It is possible. If you can't find an insurance company, contact the ALS office. A patient of theirs works for a insurance company that deals with a lot of bariatric patients.