So we called today and my Insurance group plan will not cover Bariactric Surgery. Not only will they not cover it, but they will not cover any damage you might incur if you have the surgery and there were complications. My Insurance will not pay for, nor support, any surgical efforts to control weight.
Want to know what is wrong with this picture? I live in a state that ranks in the top of the nation for adult obesity. And according to my State Health Department, I live in the region that has the highest levels of adult obesity. The State Health Department claims that obesity is the number one potential threat to people in my state and will soon replace tobacco as the top preventable cause of death.
The Health Department, like my Insurance Company, and my doctor, all tell you that you are fat. Fat is bad. Fat is killing you. You are fat because you are lazy and make poor (stupid) eating choices. They might tell you this as they are eating donuts in front of you. They all tell you to jump on one form of diet or another and begin an exercise program. But what they fail to tell you is that 90% of all diet and exercise attempts fail within two years. 90%!!!!!
So while these professionals are telling you that you are fat and lazy and stupid they are also telling you that your only hope is to engage in an program that is statistically doomed to failure. Oh, did I mention depression and suicide are real high in problems in this state too?
If you can get doctors to talk about it, where price is not an issue, they will tell you the only statistically effective way to lose large amounts of weight (we are talking for people that are termed morbidly obese.. not those that want cosmetic changes) the best safest way is Bariatric Surgery. More specifically, lap band.
But my Insurance wont pay for that procedure. My Insurance even says that if I decide to take out a loan and pay for the procedure myself and there is a problem, they will not cover me. My insurance provider, to whom my employer pays over $325 per month (and over $325 for my wife and I pay well over $325 out of my pocket for my children) says the only way to lose weight is in a process doomed to a 90% failure rate.
Now let's look at my current medical condition. I am type II diabetic. I call it the "fat ass" kind, because it is weight related. My mother, who has already lost one foot and has spent a good chunk of the past three years in a hospital is also Type II diabetic, as was her mother before her, who died due to complications of diabetes. I have high blood pressure, which doctors say is a symptom of weight. I have elevated triglycerides and take a cholesterol drug (Lipitor) due to the Diabetes which is due to weight. I have chronic back pain (medicated) my doctor says is due to weight. I may be developing sleep apnea due to... wait for it.... weight.
Dude something is wrong here! Way wrong! All of my medical problems could be cleared up, my quality of life could greatly improve, I can possibly stop a generational disease from killing me.... but not only is it not covered by MY insurance.... that same company says they wont even cover me if there were complications should I decide to pay for the procedure myself! Which then makes the procedure an unacceptable financial risk.
I have a medical condition. The recommended treatment has a 90% failure rate. I am denied realistic medical care even though I have other wise excellent insurance. This is unacceptable.
Where the hell is Alan Shore when you need him?
3 months ago