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Old 03-06-2007, 04:50 PM   #1 (permalink)
NettiePooh
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Join Date: Feb 2007
Location: Beaufort, SC
Posts: 28

surgery 5/7/07
Start Date:
Height:
Default Insurance denied surgery

I found out today that my insurance company, Planned Administrators, has EXCLUDED WLS in their coverage. I feel confident that my surgeon's office pulled out their best stuff to get approval. I called my insurance company and was also told they would not even consider it. I pleaded my case (hypertension, reflux, sleep apnea, etc.), but, was briskly informed it is not covered.... period.

Any suggestions? The cost of my surgery is roughly $27,000 at the Medical University of South Carolina. Shy of leaving the country, does anyone know if this is a reasonable price?


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Old 03-07-2007, 02:47 AM   #2 (permalink)
DocSanae
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Awwww (((((((HUGS))))))
The price itself is fairly reasonable in the US, as far as I know, but on that, I guess others know better. You can do a search and see what the cost is with other bariatric centers.
I sure hope you can find a way, I shall be keeping you in my prayers.
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Old 03-07-2007, 05:58 AM   #3 (permalink)
fr1endly2
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Join Date: Jan 2006
Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,755

Weight Statistics

June 1, 2005
Start Date:
Height:
310 lb
Start Weight:
167 lb
Current Weight:
159 lb
Goal Weight:
143 lb
Weight Loss:
8 lb
Lb Left to Lose:
46.1290322581 %
% Lost:

Body Mass Index
51
BMI Start:
27
BMI Current:

Weight Loss Method
Roux en Y Gastric Bypass
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(((HUG)))
hard when insurance companies put these exclusions in!
SORRY you have to go thru such!
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Old 03-07-2007, 08:38 AM   #4 (permalink)
leyva29
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Join Date: Jan 2007
Location: Miami FL
Posts: 84

Weight Statistics

1/15/07
Start Date:
Height:
304 lb
Start Weight:
287 lb
Current Weight:
140 lb
Goal Weight:
17 lb
Weight Loss:
147 lb
Lb Left to Lose:
5.59210526316 %
% Lost:
12/31/07
Goal Date:
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Hi NettiePooh, I just left you another message in another thread that you had. Anyways, I'm going through the same problem as you have with wls. I have sleep apnea, diabetes, hypertension, etc. and still they don't do it. It was excluded from my work ins. (lovely). I did hear it cost between $25,000 to $30,000.00. Depending on your surgeon. I had a friend that did the wls and she only had to pay like $20,000.00. You might want to talk to someone that may have done it and know about it. Or research as DocSanae mentions. Good luck!
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