weightloss surgery excluded/any hope??

bubblegum · 12-06-2007, 11:39 PM

I have preferred health systems, in Kansas. Weightloss surgery is excluded in my policy but you can appeal only after you've had the surgery. I am planning on paying out of pocket in January but I'm also going to go thru the appeals process. When I talked to my insurance they said to just make sure I have doctors recommendations, list of all diets, and all other related information. I have at least 3 doctors recommendations, been thru 2 hospital weightloss programs that I lost weight on and then gained back plus some, as well as 500 million other diets. I am 270 and 5'4. My family has a history of heart problems that are pretty severe. Do I have a chance????:help:

destiny79 · 12-07-2007, 08:51 AM

make sure its excluded, because my policy said weight loss surgery excluded but moberly obese was covered meaning that If I was a BMI of 35 and under they will not cover me because its consider cosmectic surgery but because I am consider moberly obese It does cover it has a medical prevention surgery.

Ellisa · 12-08-2007, 05:10 PM

As I understand, insurance will not cover the surgery if there's an exclusion on your policy but it doesn't hurt to try.

If you need another surgery such as repair of hiatal hernia or gall bladder and have it done at the same time, you might only have to pay the difference. My sister planned to self pay her lap band surgery. She asked the doctor if he could remove her gall bladder (something she'd been putting off) she had no idea that the insurance would then pick up part of her surgery. I don't know the exact dollar figure.