Question:
is there any way for dr to give reason other than weight loss to have this surgery?
My insurance has an exclusion for any type of weight loss surgery. — bjclark57 (posted on March 1, 2006)
February 28, 2006
If you have an 'exclusion' the only way is get a lawyer - that might help;
otherwise your screwed it will not matter what your doctor says you could
be dyeing and if you have an exclusion they will not cover it. Depending
on what type of insurance you have - ie. are you self funded then you might
br able to appeal to your employer; but basically if you have an exculusion
its your employer who put it there - so blame them.
— star .
March 1, 2006
Not that I know of...I think Star is on the right track. I am pretty sure
your dr is not going to try to get insurance to cover it by saying you need
it because you want a lower food bill. If it is something that you need,
then you might need to pay out of pocket as I did. Weigh the
costs/benefits and email if you want to chat.
— Katpts
March 1, 2006
It will require jumping a lot of hurdles, but basically you need to prove
that you suffer from major co-morbidities (yes - weight-related depression
is a big one) and you need the surgery for your survival. Do check into
Walter Lindstrom (I think that's his name) - he is a lawyer that helps in
these types of cases. Good luck!
— rebeccamayhew
March 2, 2006
I think that the R-en-Y (not the right name but I can't remember it right
now) is occasionally used for people with severe gastroparesis (when the
stomach doesn't do its job of grinding and squeezing food into the
intestines). I doubt you'd be able to get it approved for this unless you
had a severe problem... good luck to you!
— mrsidknee
March 3, 2006
It depends on what the exclusion says. If it says you cannot have the
surgery just for weight loss, then you may be able to have it because of
comorbidities, like high blood pressure, sleep apnea, diabetes, etc. If it
says absolutely no bariatric surgery, get a lawyer.
— Novashannon
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