How did you afford it?

I'm back after a long break of visiting daily while waiting for my surgery to happen. It never happened because my mother decided to not help us out financially, after she promised she would and I did ALL my pre-op requirements. I now have insurance but they refuse to pay for it. My husband and I really messed up our credit about 4 years ago so we can't qualify for any loans either. I feel like I'm stuck in concrete and I'm screaming for help but it's not there. The first time I decided I wanted to have RNY, I was 17 years old and weighed 280 pounds. Today I'm 25 and weigh a whopping 395 pounds. I have no idea what to do or how to pull this off. My surgeon's fee is $20,000 for the surgery and hospital stay. Any advise would be very appreciated.  

I received good bonuses at work at the time I had surgery and saved that to pay for it.  Do you have a 401k you can borrow against, I've seen others do that?  If your credit isn't good enough right now, work on trying to repair it.  At this point it appears borrowing money from family or a 401k is your only option.  Don't give up.

There's also the option of going out of country to a reputable surgeon that would cost less than it usually does for a state-side surgeon.

Why does your insurance refuse to pay for it?  If you meet their requirements then I don't believe it's lawful for them to refuse payment just because.  Or is it not a covered procedure under your policy?

Sorry but I don't really have any other advice.

Probably excluded which is the reason many of us self-paid or no insurance at all.  I'm curious how the ACA is going to deal with it if someone purchases off the exchange.  I know there are some states that have rules in place if a company has less than a certain number of employees the WLS rider isn't even an option to purchase (Texas use to be less than 50, which is what I deal with). 

I haven't looked at them all, of course, but it seems that many ACA policies exclude bariatric surgery in an attempt to lower the premium as much as possible.  This article from NPR News says that Texas is among the states that will not cover bariatric surgery or weight loss drugs under the ACA polices:

http://www.npr.org/blogs/health/2013/05/27/186310916/for-many-affordable-care-act-wont-cover-bariatric-surgery

The individual insurance market has been eliminated by the ACA - you may need to move to another state to get the procedure done.

Joe I'm no looking to have surgery :).  When I had surgery in 2005 there were state limits in Texas which is where I lived then.  Working for a company with less than 50 employees, insurance companies didn't even offer the WLS rider.

I'm sure many states will figure out a way to exclude WLS if they have their own exchange.  I need to research more though are you saying the federal exchange for those states that didn't form their own may be offering WLS?

The Federal Exchange does not allow any variations in covered benefits or exclusions for any plans for a given state.  The only thing that can vary is the premium and the deductibles.  So if a state does not determine that bariatric surgery is an "essential health benefit", it won't be included any plan for that state.  I got this from the healthcare.gov website.  There are some states that allow bariatric surgery.  In those cases, all plans must cover it, but the premiums will be higher for everyone.

The same thing is going to happen to employer sponsored health care next year.  It will be a state by state thing.  That means there will be states where no one can get coverage for bariatric surgery from their insurance.

While it is true that companies with less than 50 employees are not bound by requirements of the ACA, it *is* true that everyone who works for one of these companies is.  You will still have to go to an exchange to get covered.  Since the exchange allows no variation in benefits, bariatric surgery will not be covered even if you are willing to pay more for it.  And if you employer has less than 50 employees and offers a plan, it will still have to comply with the ACA, so your employer can't offer bariatric surgery coverage either.

The bottom line is that there are obese people who are going to die needlessly, because they could not get insurance coverage, even if they were willing to pay for it themselves.

It is definitely excluded on the Colorado website - worded something like "anything bariatric related"

I went on the healthcare.gov marketplace and looked at some plans from Blue Cross Blue Shield in Texas - they all exclude bariatric surgery.  Since the law mandates uniform coverage from all plans from all companies, it is safe to assume that there is no individual plan in Texas covers bariatric surgery, at any price.

(edited for spelling)

Just checked a plan called "myCigna Health Flex 5500" from the Texas exchange.  I had to dig, but it also excludes all WLS and weight loss treatments.