Question:
i was hoping to find someone who could tell me exactely what an isurance co. may look

my insurance has a clause eliminating the surgery for any and all reasons, even morbid obesity. Has anyone come across that before?    — TT (posted on November 27, 2005)

November 27, 2005
I would go to the "insurers" link at the top of the page and look under your state, then go to the "G" and scroll down to where you find Great West. There are several people that have been approved with your insurance. The only thing that I can think of is that your insurer decided to not cover it as a covered benefit. Not all policies cover everything. If you think that you are covered for WLS or anything to do with morbid obesity then appeal the decision. Good luck.
   — ChristineB

November 27, 2005
It depends on what insurance company you have. If you have Tricare..then I can give you info on that, but I would check your insurance company. They will have detailed info on what requirements you must meet to be considered. Good luck!
   — candymarie3

November 28, 2005
I am currently trying to hurry and get my surgery in b4 the end of the year, because my company is changing ins. co's and the new one also has that clause. I currently have Cigna POS and they cover it, however Aetna (my new co) require the company they are representing to opt in or out for coverage, and of course my company opted out.
   — rmc5605

November 28, 2005
Teri -- also check with your state requirements regarding what your health insurance must cover. In the State of Maryland, any HMO must cover the WLS. It seems like those who took the early plunge to have the surgery beat the insurance companies to the punch. Now the insurers are all catching on and are either deleting it as being covered, or you have to be on a six month weight loss program administered by your physician and pay the physician monthly visits. This is aslo cutting into the drug industry money as well. If a person has the surgery and was on insulin and high blood pressure medication and having WLS took them off these meds, the pharmacuetical companies are feeling the pinch as well. It's certainly the bottom line -- they'd rather you pay for all of the illnesses than to have a procedure that would cut down on illnesses -- now ain't that a blimp.
   — the7thdean