Ok ALOT of questions!!!!!

ok today was my 1st informational meeting in spokane , wa I have wanted  the RNY bypass  now for almost 7-8 months, so i made my first step.. lets start with me, im 5'7 weight 415lbs my bmi is a 62. I have never been this big all my life and im not sure there going to let me do it because i really dont have any health conditions! MY major health prolbem is my Asthma, and im always have depression. But i never been tested for diabetes, sleep apenea(which my girlfriend thinks i have),fatty liver, and so on. Plus i called my insurance and they said my work didnt take that in our plan.. I have been trying pills and diets all my life but none of them were monitored, So my question is Do you guys think they will let me in and happy again?

ADAM, WELCOME TO OUR BOARD AND CONGRATS ON MAKING TH FIRST STEP.  ONE OF THE REQUIREMENTS FOR SURGERY WITH MOST SURGEONS IS THAT YOU HAVE A BMI OVER 40.  OR IT CAN BE OVER 35 WITH 2 COMORBITIIES, SOUNDS TOO MEE LIKE YOU HAVE AT LEAST 2, THE ASTHMA AND DEPRESSION.  DONT STRESS YOUR SELF OUT.. I AM SURE YOUR SURGEON WILL WORK WITH YOU TO DO WHAT WILL BE BEST FOR YOU GOOD LUCK

Im sorry im not eaxactly sure what your question is, but Im thinking your asking about your insurance coverage. If your insurance has a written exclusion to wls it can be very hard to get it covered. I recomened you go over to the insurance forum and see if anyone has had success with your insurance. Also get your insurances written policy about wls. Begin documenting everything you do, everyone you speak with ect. I also reccommend you get a full physicall checkup so that you can document your co-morbidities if you need to send them to the insurance. In the end you might want to seek leagal advice.There are law firms out there who deal with getting approval for wls. Best wishes

Adam, Do your research talk, talk, talk, talk to your PCP, they are your ally, if they are able to refer you to a surgeon then talk, talk, talk to them.  Tell them everything!  I was more in your position, i had no co-morbidities.  You can show your attempts to take pills or diets sometimes that can help you. Welcome to the board and know that there are some people on here that got denied and had to appeal and some that got through on first application (like I did) but no matter what be firm in your decision and make those decisions known to all doctors that ask. Good luck! -Amanda

i dont really know what to tell you about your exclusion, have you thought about self pay, like getting it financed? anyways i wanted to say usually a bmi of over 40 usually qualifys, however i can almost guarntee you that you have some sort of health concerns you dont even know you have, besides the asthma, you mentioned a good one to have (for wls) sleep apnea, also high cholestrol or triglyserides (spelling) are also qualifiers. i must say though my dr put my referal in and the only health concern she put down was my uncontrolled asthma, i have a nebulizer machine, and use 3 inhalers of abultrol a month, now the insurance company doesnt need to know that i have had asthma all my life and never really controlled even was i was in normal bmi,  i did write a letter about how i needed wls, not a requirement, however strongly recommended by my physican. i just wrote things along the lines how in order to loose the weight i need to excerise, how can i go and run when i cant breathe, but of course more proffesional,  anywyas good luck with trying to find out how to get the surgery. jen

Hi Adam and welcome! Im guessing from the jist of your post your asking about insurance coverage. Sadly if it is a direct exclusion chances are (I hate to say) no. UNLESS your company has self funded insurance. Then it is possible to talk with your HR deparment to get coverage for WLS. But some are lucky to fight an exclusion and win, but usually once its writtin there is nothing you can do.  If you can get more information about your insurance coverage and ask on the insurance board I am sure they can help more.

thanks for the getting back i will look into that!   Thanks, Adam