Question:
Can someone Please help me with my Ins.?

I need to get my twin sister to have this surgery. I had it 3 years ago, I am doing great. My sister is in such BAD health that I feel like if she dont have this surgery she will die befor long. She has the same Ins. that I do BCBS but they no longer will cover it. They said wls was not longer cover under our plan. Her Dr. is all for it. They can not paid for it out of pocket or get a loan. Their income is less than 2000.00, her husband has had a stoke, heart surgery and brain surgery it is just sad.She has cry wishing she had it done when I did. So PLEASE if anyone can just give me a something that I can work with. I am going to have to be her legs for her. PLEASE HELP. I guess I am Begging but that is ok if I Can Save My SISTER    — Brendad1979 (posted on September 25, 2007)

September 25, 2007
Have you or your sister TRIED to send information to the insurance company via her family doctor and the surgeon??? Maybe if one or both of them write a letter (preferably both) with all of her health issues they will make an exception to the rule. You know there are ALWAYS exceptions to the rule!!!! It does not hurt to try this route (if you haven't already)...the worst the insurance company can do is say no. Just because they tell you know over the phone, does not mean they really won't. I think if your sister is in as bad a shape as you say and her doctors vouch for her, they would cover it. I'm sorry your sister is having such a rough time. I hope things turn around for her. Keep us posted! Good luck--we're pulling for you (and your sister)!!!!
   — ALafferty

September 25, 2007
Hi there....... Check on OH for the legal department. I went to the OH conference 2 weeks ago and they were talking about how there is lawyers on OH that might be able to help. I am 9 mo post-op. So, I hope that you are able to help your sister. BCBS is one of the worst insurance to have unless the company doesn't exclude the WLS. Good Luck!!!! Ronda
   — Ronda C.

September 25, 2007
hi my name is Terence I think what you might have to do is to get your sister to apply for social security that may help wish you luck.
   — bigman567

September 25, 2007
hi my name is Terence I think what you might have to do is to get your sister to apply for social security that may help wish you luck.
   — bigman567

September 25, 2007
Have your sister talk to one of the surgical centers in her area. Blue Cross is my insurance and they just approved mine, just had to jump through several hoops, testing, consultations, etc.... they may deny initially, but you can always appeal. Make sure you can provide family hystory, including yours, i have it all in my family, heart diseast, high cholesterol, diabetes, high blood pressure and support of my primary physician and my ob, who have both seen everyone else in my family die from one of these issues... tell her not to give up and get on line and post as often as possible for support. Your local WLS group can help you ascertain the information required by her insurance. Also, tell her to make a diary of at least the last 5 years of her weight loss trials and defeats... express the need for food, her always feeling hungary.. mention any and all of the outside and personal trials, like Jenny Craig, doctor, etc. Tell her to PUSH PUSH PUSH, it means her life!
   — blue71969

September 25, 2007
I have horizon bcbs of nj and it was covered, no problem...my bmi was just under 40. Your sister's doctor needs to call the insurance company and plead her case.
   — Sheri A.

September 26, 2007
My insurance wouldn't pay either so I had to self pay!!!!! But that was out of the question because it was going to be like $40,000 I got to checking around and decided to go to Mexico. I had a wonderful experience. I am 3 months out, down almost 60 pounds and absolutely no complications. It was all very clean and my care was excellent. It ended up only costing about $10,000. I was able to do a loan for that! I have my after care with a bariatric surgeon here in the states. I would do it again in a heartbeat. Neisha
   — neisha =.

September 27, 2007
Contact the Obesity Lawyers. They deal with this stuff on a daily basis. Maybe they know of a way to get your insurance company to cover it. It's worth a phone call or an email.
   — aer_rn