Question:
Has anyone picked up a secondary insurace to cover the WLS?
Our insurance will not cover this surgery even though it is recommended by a primary doctor for medical conditions. Has anyone found a secondary insurance that could be purchased to pay for the surgery? Thank you — Kathy B. (posted on June 17, 2005)
June 17, 2005
That is a tough question and I am going to guess no the seconday insurance
probably would not even cover you when you applied because of the
preexisting condition of obesity. So many people are denied medical
coverage because of preexisting conditions like the heart and diabetes and
obestiy. Or if they do cover you they have clauses with extended periods of
waiting before you can file a claim for something like WLS. Another thing
is that the insurance may charge you astronomical fees for the coverage.
May be someone with an insurance background can give you a better
understanding of coverage. Good luck.
— ChristineB
June 17, 2005
If you have been covered by a group plan for (I believe) 18 months without
more than a 60 day break in coverage, the pre-x clause will not apply.
(google HIPAA pre existing)<br><br>If you are talking about
getting an individual policy (not thru work), most won't cover WLS. I'm
sure there is one out there, but I have no idea who. Do both you and your
spouse work? Is insurance available at the others place of employment?
Sorry, I can't help you.
— RebeccaP
June 19, 2005
Kathy, I have secondary insurance that I am told is going to cover my
surgery as primary when my primary denied my request. I have primary
BCBS-IL which denied me due to not enough dr. documented diet history in
the last 24 months. My secondary is BCBS - Federal. So far, they have
paid everything my primary does not pay, even my co-pays. However, I have
found that all secondary insurance does not co-ordinate benefits the same
way. BCBS-Il does not pick up my husbands co-pays as his secondary, so
beware & talk to the insurance yourself with specific questions before
getting into paying premiums that you have to continue for the rest of the
year or until you have a life changing event. I'm not sure what kind of
problem you may have with the pre-existing. I have a co-worker who is
fighting this battle on her husband who was covered by his work ins. but
was layed off. She is trying to pick him up on her's now & has had to
show he has been covered by insurance due to his pre-existing health
problems. Good luck on your search.
— Diana C.
June 22, 2005
My secondary insurance through AMA has agreed to cover the surgery minus a
very high deductible, since it is a catastrophic major health plan designed
to protect you from going broke with health care costs.
Only AMA members and their families qualify for this, of course; but the
underwriter is United States Life Insurance Company. They may have some
similar plans for other groups.
Sure seems short sighted of all these insurance companies to deny this
surgery, which is specifically designed to improve your health, doesn't it?
Good luck!
— Westexan
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