I have researched this surgery now for over 7 years. I have found the biggest obstacle to overcome is the insurance agreeing to pay for this surgery. If your on Medicare they will pay. Or should I say at last contact they do. Most state Medicaid programs do. If you have private health insurance through a company you have a 50/50 chance of having the benefit.

It seems just 5 years ago all payed for it. Why? it wasnt so popular then. Now when they renew contract with your employer they leave out the part were this is a covered service. Your employer will have to ask for a rider in many cases to be placed on the policy. No its not fair for everyone to have to pay a bit more for premiums for a few that at over weight. However if you look at it closely its not fair for many to have to pay for maturnity benefits when you can no longer have children.

I have found insurance companies would rather you have a stroke, heart attack, diabetes and pay for medications for the rest of your life, dialysis machines, Drs visits every few weeks etc.... instead of having this life saving surgery that almost cuts out those risk. This surgery now is being called the Metabolitc cure. From this surgery that is so contraversial to begin with will come a cure for diabetes im sure. Did I say cure ? Yes I did. I have seen so many patients that took insulin have this done and in just a few weeks they take nothing. Not even a pill. And blood pressure patients the same way.

If there is ever a movment to demand and make insurance compnaies not deny this life saving surgery I want to know about it. To me this is a cost saving surgery. I cant wait to give up my pills and live without them daily.

I am angry that medicare and medicaid patients receive this surgery but I as a full time employee with third rate insurance can't get insurance to pay for this procedure and I don't have a chance of ever having an extra $20,000-30,000 to do it on my own. Where are our state legislators stepping up to make coverage available to anyone needing the procedure? I feel like a second rate citizen and a second rate human being.

Hi I have Medicare and I have had to go through hell I still have not got my sergery yet. I have been disabled seens 08/2001 and It took me 3 years to win my disablety I now weigh 492 and I was in a wheelchair.I lost a house a car and my creidt went to hell. I got my disablety in 2004 and I still have not got my sergery yet. so you now see that medicare is not that easey to get wls sergry. I have had a heart attack and I do have sleep apnea inlarge heart diebeits and linphdema in my legs they get very large by nite time. very depressed some times over being so over weight.Hope that I will be haveing a date soon.

my insurance paid for it and approved it within about 3 weeks.

Vickie Hey ya girl. I am so glad you popped in here and offered some insight on how insurance works.
Becka

I had surgery July 2003 when I was 22. My insurance company told me that I was too young and not "fat" enough. And yes they used the word fat. My BMI was 43, and I having problems with my knees and ankles. I just thought it sad that they wanted me to gain weight first when many have to lose weight. My mom had the surgery a few months before that, and she didn't want me to be in her position before her surgery. So, my parents helped me get a loan. If it wasn't for that I don't know. If it wasn't for that who knows where I'd be today. These insurance companies treat people like they know more medicine than your doctor, and it angers me sooooo much!!

My daughter and I have both had the surgery within the last three months and had no problem getting approved by my insurance company. She is 20 and I am 45. What scares me is what happens when we need plastic surgery for medical reasons. It is my understanding that it is much more difficult to have your plastic surgery approved through your insurance then the original WL surgery. I wish they would address that on the show. They make it appear that everyone who needs the plastic surgery gets it. They don't mention the number of people who are denied for that. If researched I bet the number of denials for plastics is much greater then the approval for the original WLS. Guess we will cross that bridge when we come to it. The show itself is absolutely awesome. I believe they are doing a real service to those of us who have been given the gift of this tool to change our lifestyle.

sallbu, they will be covering the insurance for plastics issue in a future show. I don't know if it will be before as well, but watch July 16.

What bothers me is that there is so little information out there on how to deal with the insurance companies. It is like greek to me. There are so many different companies and policies out there, and they try as hard as they can to keep us in the dark so we can't manipulate it to our benefit.

It's freaky, I don't understand the reasoning behind denying this surgery to people who would clearly benefit from it.

I get sick thinking I was on medicare for an entire year and did not realize they would approve this surgery. Now that our finances are better and we're on regular insurance, all the insurance companies in our area have an exclusion on all obesity related treatment.

My insurance took 24 hours to approve. I work in benefits I can honestly say the policies are up to how the adminstrator reads the plan. When you are denied you can request a copy of the plan document to read but it is hard to read and you may require help. Also at the start of the process call the insurance company talk to the pre-cert nurse- get to know them. Ask for their fax number and ask if there is anything else you need to do other then what the Doc is telling you. Mine told me to do the wellness program to show the Doc who would be approving me that I had really tried. I called her every time I finished something on the list. When my paperwork came thru she knew me and what I had been doing so my paperwork went right thru. My friends did the same thing and theirs was approved just as easy.

I have medicare and tricare and have been on disability now since 1993 because of my weight and the onset of arthritis in my back, both knees, and hips.
I hope that medicare will approve wls for me, does anyone have an idea how I would go about finding out? Thanks.

Hi - I had RNY 2.5 yrs ago and am now in need of plastic surgery to remove skin. My insurance will not cover it. I'd like to do my whole body (just kidding), but especially my tummy/hip area. Does anyone have any idea how much it would cost out-of-pocket for me?