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I'm an attorney and have never heard of employers working out exclusions with their health insurers. To cut costs!!!! Not to say this doesn't happen, I probably should not be too surprised -- but I should think it would be the other way around. I had BC/BS through the Feds and then BC/BS of NJ for a while but found it covered only NJ physicians and hospitals -- not for me. If you believe that your policy does not cover even the lap band (and I'm no expert, just guessing it might be the least costly procedure), I advise first going through the policy online word by word, do not take anyone's word for this, it is a contract after all -- looking for procedures under the numbers they use and whether there are co-morbidities or not. And perhaps, as a last resort, if you don't wish to self-pay, you might think of carrying different insurance for a couple of months, insurance that would definitely cover your WLS and be a lot cheaper. Good luck.
LilCaddy
I know for a fact that some employers, when pushed, remove - temporarily- exclusion to WLS in policies. I have a friend who had the RNY because of his wife's persistance with her employer (a large pharma co). Her hubby had severe diabetes and they basically fought the exclusion saying that the RNY was a whole lot cheaper to the company than ongoing care for severe diabetes and it's complications. They covered the surgery. Big companies can be compromised with...sometimes.
Ebony, start seeing a Dr. monthly who will document your diet and exercise plan and take monthly weights....this starts the process that most insurance companies require of a 6 month doctor supervised weight loss program. Also, about your leg ulcers you may want to check out a wound center and IF you currently know you have varicose veins go to a vein doctor for a free consultation - - - varicose veins can cause leg ulcers that wound care will not heal.
Finally, Tom is right. The gentleman he knows deals with insurance companies that cover bariatric surgery....this man has helped alot of bariatric patients here in NJ. Additionally, there are companies that help finance surgery such as CareCredit (I have seen info in different surgeons offices.....I do not speak for CareCredit it's just one name that I remember) they offer payment plans for medical procedures. Your life is worth it. And honestly, that is what is at issue here....
You are in my prayers!
Ebony, start seeing a Dr. monthly who will document your diet and exercise plan and take monthly weights....this starts the process that most insurance companies require of a 6 month doctor supervised weight loss program. Also, about your leg ulcers you may want to check out a wound center and IF you currently know you have varicose veins go to a vein doctor for a free consultation - - - varicose veins can cause leg ulcers that wound care will not heal.
Finally, Tom is right. The gentleman he knows deals with insurance companies that cover bariatric surgery....this man has helped alot of bariatric patients here in NJ. Additionally, there are companies that help finance surgery such as CareCredit (I have seen info in different surgeons offices.....I do not speak for CareCredit it's just one name that I remember) they offer payment plans for medical procedures. Your life is worth it. And honestly, that is what is at issue here....
You are in my prayers!
Snedly318