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I know. They said it's not self-funded but fully insured and the cost was too high with our group's claim history. I called insurance this morning and they wanted a prior authorization call from my doctors.

Read your policy carefully about what is covered. I have had pathology and my husband had anesthesia denied as not being covered but upon reading the policy they are clearly covered and when I pointed it out, they backed down. Diane S

Change insurance plans in November? That's what I had to do. When I went to my informational session at the clinic they had a print out of what common insurance plans in the area covered WLS and which ones didn't. My plan was on the wrong list .. so I kept that good list and when the next open enrollment happened I got one that covered it. It took 8 months to get the right insurance and another 6 months to follow their guidelines but I made it to the end goal.

If you get your insurance through work, consider switching jobs or if included on a family plan separate yourself from it and self pay for a year.

I am on a group plan that is fully insured with bariatric coverage listed as excluded. My company chose not to get a rider due to the premium increase for everyone and the company pays half. I really don't want to have to change jobs...all the waiting time to qualify for insurance benefits, then waiting for required wait time for pre-existing conditions. I'm miserable now, and have been doing all the preliminary stuff over the past year trying to lose weight.

You don't necessarily have to change jobs.

Call HR and ask these questions:

• Is it possible for us to get the bariatric rider for our company? Why/why not?
• Do I get a cash-back refund if I purchase my own insurance?

So, you can also purchase your own health insurance on the market place. No, it's not subsidized by your employer then, but many employers will provide a yearly cash refund if you do this. (Mine refunds us like $1200/year if we opt out) You can then purchase a policy via the marketplace with bariatric coverage. Yeah, you'd probably have to wait until January, but if all else fails you have an option.

I would absolutely call HR and request it, though. That's what they are for. They may say no, however as an employee you have the right to request it.

You can also find self-pay surgeons in the US who maybe would take payments? Usually not, but it never hurts to ask, either.

As for waiting, having been in the 700s, I get not wanting to wait. However, it will happen! It's very hard to wait, but be kind to yourself in the mean time and hang in there.

I feel for you! This is my nightmare as well, but mine was on steroids.

December 2016: Check insurance coverage and pleased to find bariatric surgery is covered.

January 2017: Make appt with surgeon.

February 2017: Surgeon recommends VSG. Office has already called Aetna to confirm coverage. Aetna requires 6 months of medically-supervised wt loss; visit to psychologist/psychiatrist and visit to dietician.

July 2017: Finally! I have jumped through all of Aetna's hoops even though my surgeon said if February that she would schedule me then if insurance would pay. Surgery is scheduled for August. Then get a call a week later...insurance is denying coverage. Claim I never had coverage to begin with. Cue hysterical sobbing from woman who was completely screwed over by insurance company. Surgery is cancelled. I file a complaint against Aetna with Aetna knowing it will go nowhere. Appeal is submitted by my surgeon's office and it is immediately denied.

A week later: Discussion with hubby leads to a bold decision. We decide to refinance the house to pull equite out because my life is more important than money. Rescheduled surgery for September.

August: Close on mortgage. I have the money to cover the surgery as cash pay. Receive a form letter apology in several languages from Aetna. Included a copy of it as well as documentation from my surgeon's office along with a nice letter to the State Insurance Commissioner.

Here is my advice to you: Keep on fighting! Your health is worth it. Appeal even though you know it won't help. Talk to whomever makes the decisions regarding the health insurance policy for your employer. Consider all avenues to fund your surgery.

Wow! So, why did the insurance send apology letter after you had it self-pay? And, why the letter to insurance commissioner? I would be some kind of missed off after doing all that and waiting, only to be denied!

I have the same insurance as you and they wouldn't cover me. I had a hernia repaired at the same time as I had the VSG done. The only thing I had to cover was the surgeon fee $5,000 and $2,300 of the hospital. Also a few co-pays for the anesthesiologist and other various things. I was out a total of $8,000 by the end of it. The surgeon did have a cash price of $15,500 which would cover everything.

You can also check out Dr. Guillermo Alvarez - Endobariatric Official Website - endobariatric.com?. I have watched a lot of his YouTube videos and follow him on SnapChat. They pick you up in San Antonio, TX for surgery. If I hadn't had it done in the states, I would have gone to him.

I sent in my appeal letter with some of the resource documents on here, but, if they do deny, I'm lining up a surgeon in Mexico a lady i work with used in Tijuana. You fly to San Diego. Her surgery price a year ago was $3,000. By the time she paid for trip to and from, she was out around$4,000. He bases his price on your health history and risks.

Have you thought about medication for helping you in the airplane... (?)