Health insurance Question regarding new changes in treatment of obesity

[e46220]

What is the name of your state? Florida.
I am need some help regarding the new changes in the treatment of obesity. I am 28 years old and lead a very active life, however, I have a problem controlling my weight and am worried about the future quality of my life. I am concerned for both my family and myself. I know that they have passed a law that now recognizes obesity as a disease and treats it as far as proventative messures, which is why I would like a procedure covered by my insurance only if they are suffering from co-morbidities.
At the current time I do not have co-morbidities which is why I want this surgery as a proventative measure for my health. I work in a very physically demanding job and would like to continue, and even improve the quality of my life.
Physically speaking for my heigth, I am 200lbs overweight which is taking its toll slowly on my health, such as trouble with my joints already. I would like to get my insurance to pay for gastric-bypass surgery and they have refused it repeatedly. I need to know what to do to get this procedure covered. I have florida first hmo insurance and desperatly need help before this becomes a problem that can not be so easily solved.
Please contact me at my email address for any answers or questions: [email protected]

 

[ALawyer]

Pressure your state legislature to have it covered.

But I doubt it will be responsive as many regard this as a self inflicted condition. plus, expensive procedures raise everyone else's heath care costs -- insurance merely distributes risk -- itnsurance does not reduce the costs overall or manufacture free money -- some things will still have to be paid by the person personally.

If this is important to you, and it should be, start saving. It's your life.

 

[CIAA]

It is a difficult situation as most insurers don't regard exogenous obesity as a "disease" and therfore not covered. As I understand it, there are 2 types of obesity; endogenous and exogenous, either of which can be "morbid". The first is an "illness" or "disease", usually metabolic, and exogenous is caused by forces outside the body. In either circumstance surgery is not usually regarded as the treatment of choice or a "curable" treatment. If metabolic or caused by a "disease", treatment should be directed at the cause. If exogenous, then they look for a co-morbidity that can't be controlled or treated any other way(ie. uncontrollable hypertension or diabetes).

Insurers have guidelines and pre-surgery protocols they look to and follow and they are not "required" to follow them to the letter. You and your doctor should talk to and work with them. You may be pleased at the results. Good luck.