Suggestions about insurers and employers with good insurance?

Sonja S.
on 7/11/04 12:50 pm - Issaquah, WA
Help! I've read the comments from those who've gotten approval for their surgery from United Healthcare, but when I talked to their customer service center, they told me my policy did not cover it, even for the morbidly obese - no exceptions. I'm wondering if this is because my employer (Barnes & Noble) has specifically excluded this procedure? Anyone else encountered this? If so, what did you do to get approval, specifically? What sorts of medical tests should I have done to show that the surgery is "medically necessary"? I have no serious comorbidities, just an extensive family history of diabetes, stroke, cancer and hypertension (I sometimes wonder if I should even bother saving for retirement, since no one in my family lives that long!). I have struggled with my weight for years, and am determined to have this surgery. I love my job, but my health and quality of life are at stake, so am willing to change employers, if necessary, to get the health coverage that will make it possible to have this surgery. There is no way I can foot the $31,000 bill myself. I've heard T-mobile, Microsoft and AT&T are pretty good. Does anyone know of other employers with insurance policies that allow for the surgery? Also, my doctor is very anti-surgery and refuses to help me with this, even though my BMI is over 40 and my hypothyroidism makes it especially hard to lose weight. Her solution is "just eat healthy foods and exercise." Does anyone know of doctors in the Seattle area that are more supportive of bariatric surgery?
kathyg
on 7/12/04 1:54 pm - Shelton, Wa
Sonja, I work for Wal-mart and my insurance thru them paid 100% I am lucky in my area we are allowed to take either the HMO or the cheaper insurance I choose the HMO (Pacificcare) I pay more per month but it is worth it to me, My uncle works for the state and he has the same insurance but his has a no WLS clause. Kathy -106
Sonja S.
on 7/12/04 2:51 pm - Issaquah, WA
Kathy, thank you so much! Very helpful information. Now, off to prepare my resume...
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