Not so good news....

After sitting through an hour and a half long seminar, I was pulled aside by a "Patient Navigator" to be told that my insurance plan doesn't cover bariatric surgery.... I'm heart broken. I cried the entire way home and I'm fighting the tears now.. They gave me three options. 1). Call my Ex (whom my insurance is through) and ask him to call his HR at Chipotle Mexican Grill and ask them to add bariatric surgery to their insurance plan. 2). Pay $15,000 out of pocket or 3). Drop my ex's insurance and get state funded insurance (Since I'm a stay at home mom and don't have a job to get insurance through). I'm at a loss and at an all time low... all my boyfriend did when I told him was nod his head that he heard what I said and told me he had to go back to work. I just want to crawl in a hole..

First off confirm she was told the correct thing.  Get a copy of the policy specifically related to WLS and exclusions or requirements.  I'm sorry you are going through this, I was a self pay because of an exclusion in insurance I do feel for you.

Three different people called for me cause they felt so bad... It's not that Aetna doesn't cover it, cause they do... it's that Chipotle Mexican Grill doesn't want to pay for it for their employees/ spouses... I will call myself when I'm a little less upset and can grasp my head around what they are telling me.

Ok yes that is right in that some insurance companies have the option to acquire the bariatric surgery rider and the companies elect not to purchase them because of the cost.  Try to breathe for now and settle yourself down.  The answer may be no right now but it doesn't mean you can't figure out another way soon to proceed.

Thank you for your support... I'm going to lay down with my daughter, maybe that will calm me down a bit.

I think dropping your exes insurance and applying for Medicaid is your best bet. Do you want to still be on your ex's insurance anyway? Medicaid varies state to state, but they generally are very good about bariatric surgery. Verify the insurance plan you have first though that they don't cover bariatric surgery before making a decision.

Something VERY similar happened to me! I live in Mass and went on state care and bam covered the gastric bypass in a month also after losing the weight they covered a tummy tuck and I am working on them covering my inner thighs. Do not give up!

Just, FYI, Massachusetts coverage is very different than what most private insurers (or even Medicaid) offers.

Lora

I'm no expert... Just telling my story.

I think I need to move to Massachusetts...