Friday, March 30, 2012

Weight loss is not covered by insurance. Awesomesauce.

This morning I am pretty frustrated with the health care system and insurance companies.  Like you haven't heard me say that before.

We have had several different health care plans over the years and I have to preface this by saying our current plan is really pretty great.  I have been very happy with this one so far.  No complaints at all.  Aside from the general red tape things that happen anywhere, like the fight I had to have to get the Big Guy's botox shipped in a timely manner.  All in all though, it was 100% covered.

If you know me (or read this blog) you know how I have struggled with my weight since I have had the boys, and how hard it is for me.  I have tried so many things... lost some weight, gained it back... vicious circle.  I meant it when I said something changed inside me after going to LA... in a good way... I was done once and for all and ready to do anything to make the change.

I fought for the Morning Mile and it went the exact opposite way I thought it would.  I signed up and paid extra money for boot camp at the Y and have only made it to half the classes due to things like Kindergarten registration and sick kids.  We were walking as a family every night before Al got sick again, and then we stopped... I have a million more excuses where all these came from.  Really it just comes down to life getting in the way and at least one out of three boys having something come up.  This week it was Bronchitis for the Big Guy.  I feel like my work out schedule becomes one week full on, two weeks off.  (And then it repeats.)

Earlier in the week, a friend mentioned a weight loss program through Miriam Hospital to me in passing.  I didn't think much of it at first.  But then last night I sat down and took a look.  A 20 week program complete with stress and exercise tests... doctor's care... 35-65 pound weight loss.  And I began to get excited.  Because I am at the point where I no longer care how it comes off, I just need it to start coming off.  Just the thought that by July (when I will be at the beach weekly) I could be so much skinnier... and I'd be active with the boys at that point anyway... I got excited.  Al and I talked about it.  This morning I called our insurance company to see what they might cover out of it.

You know how much I love being online.  I do just about everything online.  But I called because I wanted to speak to an actual person about it.  It's so awesome to call your insurance company, only to be told (before they help you):

You know you can always go online and look these things up...

I explain very little about the program.  Only that it is weight loss through Miriam Hospital and I am told to wait a moment... then the woman says this... Surgical OR non surgical treatment of obesity is not covered.

As in end of story.  I am so surprised because I had really thought a portion of it would be since it's through a hospital and you see doctors and all.  I think I haven't heard right.  Um, nothing is covered out of this?  At all? 

No she says and starts to repeat what she already said.  I say thanks and hang up because inside I am screaming.  How is that possible?  I'm not asking for them to cover weight loss surgery.  I'm saying hey I want to get healthy and am having a really hard time.  Honestly it blows my mind that they would 100% deny this sort of thing. 

Wouldn't they want healthier insureds? 

Doesn't that translate to less money they shell out in the long run?

Just... why...


  1. You were thinking logical about this in terms of what your insurance company will cover.

    Remember : Insurance companies would rather shell out the money for you to HAVE a baby, then to plan and use contraception such as the pill.

  2. so true! that is another thing i always thought should be covered. smh.

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