Question:
WHERE DO YOU GO NEXT WHEN YOU HAVE BEEN TURN DOWN.

MY INSURANCE HAVE AN EXCULSION CLAUSE FOR WLS THEY SAY BUT I AM NOT SURE IF THERE IS ANY WAY AROUND IT. IT DOES NOT STATE EXCULSION FOR SURGICAL WIEGHT LOSS IT JUST SAYS FOR OBESITY. SARAH    — sarahwagnerwhite (posted on June 1, 2001)

June 1, 2001
I would recommend having a lawyer look at the legal aspect of your policy. If anyone can find a loophole, they can. That would be your best bet at the moment as anything we would say would be a guess. You may have to change insurance. If so, what at least 90 days before you see someone about WLS or they will say you have a "pre existing condition" and then they will have cause not to cover you for it. I have undergone gender reasignment surgery and I had to look around "carefully" for a company the would cover it. You have to be carefull what questions you ask... you probally would dare come right out and say "does this policy cover WLS". Why insure a house that's already burning? But first off, see a lawyer. Then you may have to change insurances. If you do, look at the pages on this site for people who already had insurance that covered it. Especially people from your own state! Then email some of them and find out how difficult it was to get approval from the company. I know I had a H#$ of a time with Blue Choice Option here in Upstate New York! They made me wait nine months. Everyone gave approval but they kept sending me to more and more people trying to get a denial. This is why you should contact people in your state to find out if they had to go through all the crap the BCO put me through. Good luck.
   — Danmark

June 1, 2001
Have you read your policy or is this something someone told you over the phone? You need to get the policy in your hands and read it yourself. By the way, my policy specifically excluded treatment for obesity and ironically, that's how I found out WLS was indeed covered. The language was something like, "treatment for obesity is excluded, except in the cases of MORBID obesity". Believe it or not, you are working with two distinct terms here and it can make a world of difference. Good luck to you.
   — Allie B.

June 2, 2001
I have read under the insurance section for Texas that instead of Vocational Rehabilitation its called Texas Rehabiltion Comission and they have covered this surgery. Hope this helps. Debbie
   — deborah D.

June 3, 2001
Sarah..... I was denied by my insurance. I went to the county that I live in and applied with the Voc. Rehab. You have to have a copy of your letter of denial ( speeds up the process if you take it to the V.R. with you ). You have to prove to them that you have been denied in order for them to pay. I have been trying to have this surgery done since August of 2000 and I just got approved with Voc. Rehab 2 weeks ago. It has been a long process and alot of "red-tape". Good luck. If you would like to ask me anygthing else, feel free to email me [email protected]. I will be more than happy to answer anything that you would like to ask me. :) Again, GOOD LUCK
   — Alice C.