Lots of heartbreak here

My BCBS has positively refused any talk of  Bariatric Surgery.  I guess they would rat her pay for my spinal surgeries, and i am not going to be having any more of those.    I can't possibly finance the surgery myself, and have gone every route I know to look for a clinical study I could get into.      There ends the hope, and my presence on this forum, as it is a little depressing believing of what might be possible that has become the impossibility.      

May God Bless each of you who have succeeded in obtaining the help you needed and deserve.  iw sih you continued success on your journey to better health.  It feels as if Blue Cross just signed my death sentence this week, and right now, I really dont even care that they have.   The spinal problems got me on social security disability, and that took away my job and my pride.

What a tangled web this life can lead to.    Fifty six didnt seem old last year...now that I am there, I hope it means the end is coming soon for me.

God's Peace
Jane Tatum

Does you policy have an exclusion for WLS - if so you can try to fight it.  I would check out the insurance board and ask if anyone has the same insurance as you with the same exclusion. I have heard of MO people fighing the insurance because the exlusion says treatment of obesity but what you are asking for is the treatment of morbid obesity - it may be a long shot but please do not give up.  Fight Fight Fight...I was in your same boat last year.. I thought it was over.. no insurance no surgey but things change and so do policies - Keep your chin up and please don't leave the forum. 

Dont give up, from what I have heard its BCBS does alot of turning down letters... And I have also heard it has alot to do with how it is writtin.... Praying for you, that God lifts your spirits and gives you a will to fight this...

Do you get the BCBS from an employer or spouse's employer?  Contact the human resources or employee service center there and try to find out if they have ever covered anyone's wls, and if so what qualifications.  Do you know of anyone that they have covered?  Many times they say no and you do have to fight them.  If its a matter of being an exclusion all together and they have never paid for anyone's, you might be right and not able to get it.  However, make sure you have exhausted all forms, barked up every tree, and dotted every i, crossed every t before giving up all together.

Jane, if you are on Social Security is this not the time that you can change your coverage? My husband just got a new book in the mail yesterday. Can't you see if you can find a carrier that covers WLS?

Don't give up you need to fight this. Medicare covers WLS looks like SS would also?

56 is not OLD at all, please exhaust all avenues of help. Write an appeal letter and talk to the appeals people here on OH. Don't give up you have a long time to live!!

Please don't give up....That's what the insurance companies want you to do!  If you give up, they don't have to shell out any money.  I was told that if I was denied, they would get your WL surgeon to get involved.  Appeal, appeal, appeal! 

Please don't be sad....stand up and fight!  God Bless you!

jane, this comes from the heart. In 2004 I was denied by 11 surgeons. That was before I found out I had diabeties. In 2005 I was diagnosed with Leukemia. My surgeon that did my surgery agreed to do my surgery as long as my blood counts were in normal range. I too was about to give up, leave the board, even though of suicide. This board helped me. I figured why try since I have leukemia. My surgeon worked with my oncologist and I had my surgery in January on 2006.  I am still on chemo that I have to take daily. Protein shakes are not on my list of items as the chemo rejects them in a heart beat. 

Since you are on Social Security, Medicare will pay for the surgery, but you have to meet their guidelines.  They pay 100% of the hospital bill. Granted you may have to pay for office visits, but check into this. Medicare paid all of mine and I was in the hospital for 5 days because my chemo that I was taking while a patient kept me pretty sick and lowering my potassium levels.  I never saw a bill.  But I imagine it was over $100,000.  I know sometimes BCBS is primary and other times it's secondary.  They have been known to change their minds, but you have to fight them on a daily basis.

Please don't give up, your life is worth fighting for. I know. Been there.  You're in my prayers, Kathy