Insurance Companies Suck

My husband wants to have this surgery too. We went to the information meeting (see post http://fat-chronicles.blogspot.com/2006/11/informational-meeting.html ) together and he got scared. I knew when he saw how well I was doing that he would want to do it too, and that is exactly what happened. Because he is a school teacher, he wanted to wait until the summer to have the surgery.

He knew the drill as far as all of the tests that you have to do before you see the surgeon and so he started doing all of that in April. He made his appointment with the surgeoun for July 5th. After the meeting, the surgeon will give you a surgery date and then they will secure the authorization for the surgery with the insurance company.

After his meeting, my husband was told that he would not be approved by the insurance company because the insurance company added a new stipulation for approvals last week! In order to be approved for surgery you now had to have 6 months of supervised weight loss with a nutritionist & physician. Our insurance company is Horizon Blue Cross/Blue Shield. They had been the easiest of the insurance companies to get the approval for bariatric surgery.

The insurance companies are trying to dissuade people from having the surgery because it costs them too much money. I think the surgery costs around $35,000 and since it has been so successful in weight loss, people are lining up to get it. The more obstacles the insurance companies put in your way, the less likely people will follow through to have the surgery.

He was so disappointed. He was really counting on having the surgery this summer. He is following up with his new PCP, Dr. Fink, who was going to do all of his post-op routine visits. Dr. Fink is going to set him up with a nutritionist. He is also starting a work-out regime at a gym that is affilaited with the hospital. It has lot better hours than the re-hab hospital gym that he was going to. It is like a regular gym and opens at 5:30 and closes at 9:00 pm. Gym memberships for men are pretty limited. At least women have women only gyms, but men pretty much have things like Gold's Gym or Bally's and they are clubs that you dodn't feel comfortable being at when you are overweight.

Anyway, I say screw the insurance companies. Follow their requisites to the letter so that they will have to pay for your surgery. Make them pay!