My Insurance refuses to cover anything related to OBESITY

JIMSMOMM
on 2/2/05 4:06 am - Strongsville, OH
I have learned that regardless of all the serious medical conditions I have, my Insurance company have riders that state they will not pay ANYTHING if the word obesity appears anywhere in the diagnosis. It's time for me to panic. I'm going to be 58 this year and I need to drop at least 150 pounds. I understand that the doctors will not perform this bariatric surgery on anyone over 60. I'm so disgusted and depressed, I've tried so many other things and have failed. Does anyone know anything about possible grants or avenues that I can investigate? Thank you and the best to all of you.
Sue
on 2/2/05 4:35 am - Barberton, OH
MaryAnn, Talk to your surgeon's office and see what they suggest. I know that St. Vincent's takes your insurance as well as the surgeon's. I do know that they have the 60 year cap. I am going to University Hospital and they evaluate you as an individual they do not have an age cap. They do not however take your MM plan. If you self pay UH is $7,000 less than St. V's. I have MM too, but a different plan. I do not have exclusions like you suggest. I think that is up to the place of employment and what they dictate. Did you call MM and ask them specifically what you need to have it approved? They will let you know what your plan does and doesn't cover. I am lucky that ours will pay 100% if you meet all their requirements. I am now appealling because I don't have a 5 year weight history but UH called and they are going to reconsider it. Keeping my fingers crossed that they approve! If not I will self pay because I feel that it is the only way to get and keep myself healthy! I have researched both hospitals and am going through UH! I love their support system. Please make sure to check out both programs! Sue
JIMSMOMM
on 2/2/05 4:49 am - Strongsville, OH
Thanks for letting me know about UH, I will investigate them too. I've already checked my insurance through my employer. They have specific riders on obesity. Will not pay hospital or physician bills. It's such a pity. Maybe I can find someone that will take payments. I appreciate your comments and wish you much luck.
Lucky Lu
on 2/2/05 7:27 am - Collins, OH
Dear Maryanne, My husband works for UPS and I have the same problem. His Blue Cross/Blue Shield of Illinoise has denied me and his Aetna has too. I am 53 and have sleep apnea, diabetes, HBP, high cholesterol, arthritis, can't breathe after climbing one flight of stairs. I weigh 311 and am 5'2". I'm very depressed. I'm also in couseling to heal from being sexually abused as a child. I do plan on talking to the UPS district and regional Human Services Dept and the Teemsters Local 20 to see if I can get help. Do you have any of those options to go to with your insurance? LuckyLu
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