Question:
what insurance companies will pay for the surgery
I need to find an insurance campany that i can get that will pay for this surgery. My insurance has an exclusion in the plan. I need a company that will accept individuals. — allison M. (posted on September 8, 2001)
September 8, 2001
I am not an insurance agent but through my reading on this site and others
I see where Blue cross blue Shield seems to cover these surgeries when it
is a medical necessity. I have federal BC/BS but I have not applied for
approval yet.Whatever ins you decide on be sure to ask if there are
exclusions for prexisting conditions or a waiting period.
— Sue C.
September 8, 2001
Not all BC&BS covers the surgery. Federal does, in my state most other
BC&BS plans don't.
— [Anonymous]
September 8, 2001
Aetna US Healthcare has a good written policy about WLS. Employers
apparently can write exclusions to that policy, but the three companies I
know with Aetna have not done so. The conditions that Aetna sets
are:<ul><li>BMI of 35 or over with significant co-morbidities
(such as obstructive sleep apnea, stress incontinence, severe
diabetes)</li><li>BMI of 40 or over, no co-morbidities
required</li><li>documented history of repeated failure of
physician - supervised medical/dietary therapies</li></ul> Most
of us would easily meet those criteria. Here's their policy:
http://www.aetnaushc.com/cpb/data/CPBA0157.html which includes the policy
on revisions as well. Good luck finding good insurance!
— Julia M.
September 9, 2001
Don't get United Healthcare - they usually don't cover the surgery. There
have been some who have been lucky enough to have a policy that doesn't
exclude it, but most of the time - we have exclusions and they don't budge.
— [Anonymous]
September 9, 2001
I have BCBS of Fla. they approved in two days. There is an exclusion in my
policy, but it was proven to be medically necessary .
— Gail M.
September 9, 2001
Has anyone had any experience with Cigna PPO in Northern Virginia?
— Becky B.
September 10, 2001
I personally have had one heck of a time and can't find a single insurer to
take me on except my employers plan. Its hard to find an insurance company
that takes individuals because my weight is so high and I have
comorbidities. I wish you luck.
— Dawn R.
September 10, 2001
Hello, PacifiCare HMO Colorado, what I have, seems to be pretty good to
approve. I have talked to other PacifiCare members from other states, and
they too have been approved, some have had to jump through hoops to get
the approval, but none the less got the approval/surgery. They might be a
good choice to look into if it's available to you.
— Carey N.
September 11, 2001
I have DakotaCare insurance and no problem getting approval. It took a few
days to get approved once my letter was sent from my surgeon.
— Lori K.
September 12, 2001
Almost all insurance companies will pay for Weight Loss Surgery. You have
to look into specific "policies" of different companies. For
example, my insurance company, UHC paid 100% of my weight loss surgery and
plastic surgery with me paying my copay of $10. My girlfriends United
Health Care policy had an exclusion and paid $0 for her weight loss
surgery. Same company--different policies. Don't write off a company
because of an exclusion--shop for a new POLICY. Good luck to you! ...
http://www.mywls.com
— [Deactivated Member]
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