Question:
dying from something

The surgeon told me that the insurance company says I need to be dying from something to do the surgery. Any help would be appreciated    — SidheLady (posted on June 30, 2006)

June 30, 2006
what insurance do you have? Ask what they mean by dying, because you can die from being obese or heart disease or diabetes caused by weight. You have every right to question. Also i would find another surgeon as well as ask your PCP give you a recommendation for this surgery. Good luck
   — Jenney

June 30, 2006
maybe he means co morbidity, you need to look up your insurance and find out what your insurance will cover and when and why. Every insurance is diffrent. i would find another surgeon if he is not being helpful. His billing person or cordinator should of hellped you out. good luck
   — T. Rosario

June 30, 2006
Do you have high blood pressure, sleep apnea, diabetes or high chollestorol? All are co-morbidities. Death doesn't have to be imminent in order to be approved!
   — sandsonik

June 30, 2006
Also, go online to your states website and see if the state has passed any law regarding the coverage of persons seeking WLS. In Maryland, if you work for a company that has over 50 employees, you can't be turned down.
   — the7thdean

July 1, 2006
I believe all insurances require medical necessity. As another responder mentioned, high BP, sleep apnea, diabetes, all would be life threatening. All can kill. But some insurances are worse to deal with. Follow their rules and if wls is not specifically excluded, you should be able to get it, provided you meet the qualifications. I believe that even if it is excluded, sometimes with a lawyer, you can get it covered if you have a condition which can kill you.
   — geneswife

July 1, 2006
Check exactly what they mean. Check with yourijnsurance, not your dotor. Ask the insurance company for the clinical guidelines for the surgery.
   — Novashannon