Question:
**PLEASE answer my ?'s**

My insurance has an exclusion policy for obesity loss thru surgery, no mention of morbid obesity. Anyone know the likeliness of getting WLS approved for morbid obesity? Also I have thought about changing insurance, but have already had consultation and started pre-op tests. Might this be a pre-exsisting condition? I want to have surgery mid December, only about 10 wks from now. Any comments would be greatly apprecitaed. Also any notes on self-pay? **Thanks, LOL & God Bless***    — Lisa W. (posted on September 30, 2002)

September 30, 2002
Don't give up! Many people have had ins. that excluded WLS but through appeals got it approved. If you have a PCP who is supportive and willing to write a letter of medical necessity, most ins. companies will eventually approve WLS. You'll probably have to "qualify" with at least 2 comorbid conditions. If you are thinking about switching insurers, you should try to get on a group plan through an employer or spouses employer. If you're on a group plan there are no pre-existing exclusions, but if you go with private ins. they will have exclusions and may require a physical exam. And they will charge a higher rate since you are obese. Just a few things I learned while searching for my own ins. a few years ago. ;) hope this helps a little! GOOD LUCK :)
   — Trula B.

September 30, 2002
As long as you do not let time lapse between your policies, it is not considered a pre-existing condition. It is very important to keep continuous coverage of some kind. It is usually wiser to switch to a PPO plan with one of the major insurance companies. They are more likely not to have exclusions. Sometimes the premium may seem high, but in the long run it is still cheaper then paying cash for a procedure. We had to switch insurance companies because of my work. My husband who has been on a liver transplant list for over a year with the prior company is fully covered with the new one. He just recently got insurance at his place of employment and they have to cover him because his primary insurance (through my work) already does. When you get into legalities, they don't want to be the ones pushing the buttons. It could be far more expensive.
   — Sue A.