Has anyone EVER been approved for WLS w/ OHP? I was denied.....

I had OHP/Open Card during 2003, my PCP sent a very informative,eloquent and thorough report to the powers that be at OHP asking for pre-authorization for WLS (which he wholeheartedly recommended to me based on my co-morbidities). OHP denied surgery, saying it was not a covered service. However I am very thorough, and I had done my research, I checked OHP's Line Item list of covered treatment/procedures, and WLS surgery IS,indeed,COVERED,- IF it is MEDICALLY NECESSARY AND ACCEPTED TREATMENT FOR THE CO-MORBIDITIES (of the patient)- My BMI-62, weight 330,height 5'3", age 50, hypertension, arthritis and extreme pain in the weight bearing joints, shortness of breath on exertion, major depression (i wonder why ?),anxiety,GERDS,hiatial hernia,back pain,hypoglycemia (borderline diabeties)and Hep C, which my liver specialist won't treat (with interferon recombatant therapy-chemo, basically)until/unless I lose enough weight to bring my BMI under 40- can you believe that? If I were able to just "lose the extra 200 pounds or so", don't you think I would? Guess who's shopping for a new liver doctor! My point is this- OHP would (in my case) prefer to continue to pay for expensive medications and treatments FOR THE REST OF MY LIFE than to SEE THE BIG PICTURE! That's just ridiculous!...My health gets worse with every passing day, for real, and based on family history, my life expectancy is in the low to mid 90's. I don't think I will make it to my next birthday (in July)without the WLS. ... I am sure that I could get Social Security Disability and Housing and Food Stamps and OHP for the rest of my life, but I want to get better. I want my health and MY LIFE back. I am a single parent who's youngest son turned 18 in July 2003,(my oldest is 33)and I want to be around to see my grandkids arrive and my children thrive. WLS isn't just something I WANT, its something I NEED, just as badly as I need the air I breathe! I've always had good jobs, but got laid off and was out of work for over 2 years, Oregon has the highest unemployment rate in the nation,you know. Instead of applying for SSD, I decided to take the first job I was offered that had good health benefits attached. My current job started out at just over minimum wage, which just barely stretches far enough to pay our rent, but not all of our normal monthly bills. We have cut back on everything. No more cable tv, no more fast food, dining out or going to the movies, or trips to the beach. It sucks, but my benefits kicked in 2 weeks ago and I am just waiting to hear that my medical benefits have begun before I start scheduling appts. I selected the EPO option, even tho it was the most expensive way to go, because one of the carriers is United Healthcare, and my EXTENSIVE research online says that the ROUTINELY APPROVE WLS,in fact, I havent seen any feedback saying anyone has been denied by them. I can self refer to specialists, and will have a $250-co-pay with 100%of the rest of the cost of surgery (inpatient OR outpatient) paid by United Healthcare. I will keep you posted on the website message board. Please, people, SHARE WHATEVER INFO & SUPPORT YOU HAVE WITH ALL THE OTHER FOLKS WHO ARE RUNNING INTO THE SAME BRICK WALL YOU ARE-NO ONE NEEDS TO TRAVEL THIS ROAD ALONE. ******* As for Oregon Health Plan, it angers and frustrates me so much to know that I have always been a productive member of society who's paid plenty of taxes to this state and to the federal government, and who, now, I need the help, can't use the benefits that my contributions (taxes)are supposed to be paying for. I PAY TAXES,WHY CANT I GET THE SURGERY I NEED TO SAVE/EXTEND MY LIFE? ...SIGN THE PETITION! We can change this if we all work together, dont let those who come later have to fight the same battle, if things dont change, we all lose.

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