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WLS - Information
The Insurance Approval Game


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Important Information:

Some Insurance Companies will be straight forward and give your doctor an approval right away. But other Insurance Companies may not. In my experience you should be prepared for the worst and then if they roll over you can relax. I have tried to compile a list of things that will make your case better when you or your doctor contacts the Insurance Company.

What kind of insurance do you have? Take a look at your policy and see if WLS (weight loss surgery) is mentioned. If it is clearly listed as a non-covered proceedure then you know you are in for a battle. If you are unable to determine by the language in the policy take time to see your doctor or his insurance clerk. They will be able to help you understand where you stand before the process starts.

Where do you start? What do the insurance companies need to know in order to give you an honest review? Think about these things as you write up your story.

I'm sure your doctor will write the letter for you but be sure he knows all your medical problems, past and present.

Describe your life long progressive disease of fat storage.

Then list your co-morbilities.

List your serious Medical and Physical problems:
- Considering your heart, lung, bone and joint disease, diabetes,
- hypertension, sleep disorders, shortened life span,
- and the many other medical problems related to obesity.

List your Social, Psychological and Economic problems:
- The frustrations, the tensions, the discrimination due to obesity,
- the impaired self-image, - and lost opportunities of participating in the physical and social joys of life.

List in as complete detail as possible all the methods of weight control you have tried.
- Such as calorie controlled diets, behavior modification courses,
- Protein sparing modification fasts, prescription medications for weight loss,
- workshops and their various topics such as low-fat cooking,
- dining out on a diet, supermarket smarts and other topics.

Be sure that you list and describe - your success and your failures in attempts to get your weight under control.
- Tell how each failure made you feel,
- how the weight came back,
- and with each failure came more weight to have to loose.

I hope this will give you a little guide line of what the Insurance Company will want to see in order to make their decision. If you keep this list with you and a note pad, when you remember more of what you have done: make notes. It is almost impossible to get it all the first time you try. The more you think about this the more you will think of to put on your list. So carry your note pad with you, it is easy to forget some of the most wonderful ideas that are not written down.