Question:
Has insurance covered under 18 WLS??

Does anyone know if an insurance company has covered a patient under 18? My niece needs this surgery to literaly save her life!! Her parents can't afford self-pay. Anyone have any suggestions or insurances that have coverd it for teens. [email protected] God Bless, Lydia Cook    — Will2LoseLydia (posted on April 26, 2003)

April 25, 2003
I am not sure regarding insurance coverage to a minor. However, you may find problems when looking for a surgeon, due to the malpractice insurance that surgeons must take out. This question came up at our support group meeting the other day, and my surgeon can't do it on anyone under 21! He's trying to get the malpractice people to change their policies. Good Luck.
   — Sylvia E.

April 25, 2003
Aetna's criteria includes the following: "Patient has completed growth (18 years of age or documentation of completion of bone growth)" If the doctor can document (via X-Rays) that the growth plates have closed, then that could satisfy Aetna...JR
   — John Rushton

April 26, 2003
Yes some insurance companies will cover those under the age of 18 including Aetna. I have done so major research regarding this particular request and even though policies may sometimes state they will not that is not entirely true. There are medical necessity issues that insurance companies will look at much more than normal. As a matter of fact I have a friend who is 16 who is having the surgery in May.
   — Kitty Kat

July 26, 2003
My 13 year old daughter had WLS last year with Dr. Albert Wetter, Burlingame, CA, 650 -652-0600. Our insurance, Great West PPO paid for the operation due to her many co-morbidities and (this is key) the opinion of a Stanford endochronologist that she was DONE growing. (Girls finish faster than boys, she had menarch at age 10). Good luck!
   — sandieguy