Insurance Company Covers Bariatric Surgery But Denied Me

Question Below Submitted By:  

Jamie (a patient from Hulbert, Oklahoma )

My insurance company turned down paying for bariatric surgery, what do I need to do so I can have the surgery?

Humana pays for bariatric surgery but turned me down because I am bipolar, stating I am non compliant and have COPD, which I have never been told I have. Most of my medical issues would go away after weight loss surgery and greatly improve my quality of life.


Expert Responses to the Question Above

Response to Insurance Company Covers Bariatric Surgery But Denied Me

by: Jeff

Hi Jamie,

I'm sorry to hear about the problems with your insurance company. I know what a hassle they can be to work with. Here are some initial thoughts...

1. Do you meet the body mass index requirements for bariatric surgery?

2. If you do, what process did you follow for requesting approval?

There are several WLS insurance approval steps you should take (click the link for more info) that include involving your local bariatric surgeon AND primary care physician and having them draft and send letters of medical necessity for your insurance company.

If you haven't done this already, it may help change their minds.

Keep in mind that experienced weight loss surgery practices work with insurance companies all the time and can help you through this process for free. Use them.

3. If you're still denied after trying the above, please review this page about appealing an insurance denial. Appealing a denial is a lengthy process, but you can be successful if your situation meets certain guidelines.

4. If the appeals process does not work, you can make surgery affordable through various financing options.

Review these 7 weight loss surgery financing options to see whether one or more fits your situation.

I hope this helps, and please do come back to this page and click the "click here to add your own comments" link below to let us know what happens.

Good luck,

Related Pages:
- Financing Bariatric Surgery - 7 Options You Should Consider
- Bariatric Surgery Insurance
- Medicare Bariatric Surgery
- Weight Loss Surgery Mexico & Abroad: Complete Analysis

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