Humana direct exclusion - ThinnerTimes

biggie · 06-04-2008, 05:06 AM

Well, it appears that my WLS journey has ended before I even got out of the gate. I went to the surgeons seminar Monday evening and found it very informative so I decided to take the next step, insurance approval. My Humana PPO has a direct exclusion for ANY type of WLS so here I sit trying to figure out what to do next. Any suggestions? I am one sad biggie right now.

SueRN · 06-04-2008, 06:37 AM

IF the exclusion is from your employer, then you are stuck. Some employers offer different insurance policies but will exclude the same things on all of them. I would discuss this with the benefit administrator usually found in the HR dept. They may be looking to change their mind in the future. It kills me that employers don't want to pay for something that would improve an employee's health! Another option, and it's a drastic one, is to look for another job that has benefits that covers WLS. I used to work for Duke which has an awesome program that is a Center of Excellence and everything. But guess what? Duke EXCLUDES weight loss surgery! Tell me if that isn't a kick in the ass? Their employees have to perform the surgery and take care of these patients and promote it's program, but won't let their employees get the surgery. Good luck to you. Sue

biggie · 06-04-2008, 11:17 AM

I'm not sure if it is an employer exclusion but I work for WalMart so it probably is, so much for them caring about their employees. I am looking into medical financing but that is probably not going to happen because of my 'sub-par' credit history.

timidcharm · 06-09-2008, 07:59 AM

I have Humana PPO advantage plan and WLS is a covered benefit... Must me the group policy offered by your employer

Godsblessedme · 06-09-2008, 08:49 AM

i just read that article yesterday that Walmart is one that excludes the surgery its not your insurance. Its walmart. There too cheap to pay for that write in on the policy

i'd say start a job search. i'm so sorry

Josephine · 06-09-2008, 09:24 AM

Yup I read it too

Screw WalMart... Grrrr...
How long have you been with them?
If you're serious about this being the only way for you, you gotta switch jobs. You do not wanna take on a $20,000 debt for this, and if you have bad credit I don't think you'll have much luck anyway. Find some people who've had it done in your town and get a job where they work and the insurance that they have. Are there any factories around with good insurance?

KathyV · 06-09-2008, 10:07 AM

Try getting a part time job that has benifits. I know that Starbucks and Office Depot have benifits for their part time employers. Good luck

biggie · 06-09-2008, 02:45 PM

Well that just sucks. I've been with them for almost 2 years and had hoped to stay longer, I hate job hunting and I can't stand factory work. My policy won't pay for any type of weight loss program, that means no WLS or medically-supervised program. I guess WW here I come-AGAIN!