How can I get my health insurer for my weight-loss surgery?

Your doctor might recommend weight-loss surgery if you are more than 100 pounds overweight. Even with your doctor’s recommendation, your health insurer might refuse to pick up the tab.

If that happens, try to appeal. If you have well-documented attempts of attempts to weight loss including diet and exercise that failed, you might use that as back-up to support your appeal. Keep in mind that many insurance companies are pressured by a number of appeals, so keep trying.

In 1999, 61 percent of all American adults and 13 percent of children are obese, according to the Office of the Surgeon general. They also say that 300,000 deaths are caused by obesity each year. Weight-loss surgery basically treats people who are so overweight that there are health problems that are caused by your obesity.

These health problems, like any health problems, increase your chance of dying. If you are going to appeal, try to get evidence that your obesity is hurting your overall health and might lead to serious medical issues. Surgical treatment of morbid obesity is usually involved with operations on the stomach such as gastric banding, vertical banded gastroplasty and gastric bypass, according to the American Obesity Association (AOA).

If you’re asking how much you have to weigh before a doctor will perform the operation and your insurer will pay for it, this can be answered by the body mass index (BMI). In order to determine your BMI, you need to divide your weight in kilograms by your height in meters squared. If your BMI is 25 to 29.9 then you are overweight, but not obese. If your BMI reached the number 30 or higher, then you are obese.

If you want for your insurance company to pay for the surgery for you, then your doctor will have to provide proof that you have tried and failed using non-surgical weight-loss therapies. When speaking to your insurance company, here are some tips that might help you get what you want:

Speak to someone who knows your health plan and who you think is appropriate to talk this over with. If you get transferred to a customer representative and believe that it would be best to talk to someone higher than that, ask for the manager.
Discuss your needs with your health benefits manager at work.
When speaking to your insurer, be calm and respective of the people you are speaking to. 
After a phone conversation, sent the insurance company a written letter repeating your concerns and requests.
Ask your doctor to speak with the health insurance company. Your company might take the case a lot more seriously if they talk to someone who knows your medical condition better than you do – your doctor.