WLS on the news tonite

Watching the evening news, Dr. Nancy Snyderman was talking about WLS and stating that there will probably be more surgeries in the coming years because of it's successes in getting overweight and obese people off of medications for diabetes and other diseases.  They featured Gastric Bypass and the Vertical Sleeve.  I wonder how soon this might make a difference in getting insurance companies to approve the Sleeve more than they do now.

Not much to say about the renown Doc though.  She was on another news type story a few months back, stating that obese people are not as intelligent as their more slender counterparts. Indicating that if they were more intelligent, they would not be obese.  She hasn't impressed me since.

WLS makes so much sense because for a small upfront expense they save so much money later by not having to treat complications like ulcers, amputations and frequent hospitalizations. It's cost effective health care! Imagine that, something that makes a lot of sense!

I am choosing to have my surgery now before I develop diabetes and high blood pressure.

I am NOT a fan of Dr. snyderman (and therefore ABC 'news') since she was on GMA spouting her thoughts about infertility ...... Her speciality is otolaryngology ... And she was trying to pass herself off as a reproductive specialist.

Completely Not impressed.

Insurance companies don't make the decisions about what coverage to offer for group coverage (which, for now, is still the bulk of coverage in the U.S.).  The employers look at the cost trade-offs for the types of coverage available, and because the surgery is so expensive and because there are often additional post-op expenses for complications, they see the increased premium cost and they opt not to pay the additional premium to cover it.  

A former co-worker who is currently employed only part-time was hoping to find a plan on the Obamacare website that would cover WLS, but there weren't any (and she had not been able to find an individual plan that offered it, either).

Lora

@****rogirl,

not that I want to argue with anyone but not exactly correct on that post.  I am on disability and while a boss's decision has nothing to do with MY insurance(s), I can see where you could be right if the decision is made as an "average concensus" by employers nationwide.

Also, because my first insurance will cover bariatric surgery, but NOT the sleeve, I took out a second policy on the Obamacare Healthcare Marketplace and just paid the first premium on the policy I bought there and it will cover 50% for the sleeve or any other bariatric surgery, on an individual plan.  I spoke to the insurance company directly to make certain it covered the sleeve and it does.

I wish your friend was able to have gotten someone who actually knew what they were doing.  I spoke to a few on the marketplace who didn't have a clue and I had to have them read the verbage to me and pointed out which definition was the vertical sleeve.  I then hung up and later called again to get another agent who did know their stuff.  I then called the carrier themselves for finalization.

Sorry your friend lost out there.

Individual employers who are "self insured" absolutely DO determine exactly what coverage they want to include and not include in their group policies for their employees.  It has nothing to do with a consensus of multiple employers. They employe enough people that they can pick and choose when it comes to thinks like WLS, chiropractic care, certain kinds of fertility treatments, etc..  Because of this, they can also choose to add coverage at will and discontinue coverage at will.  My employer originally did not offer WLS coverage, added it for a couple of years, and then dropped it again.

I am glad to hear that you were able to find a plan on the Marketplace with WLS coverage.  It is encouraging to hear that in some places they are covering it.  Apparently Ohio is not one of those, though, because the ex-coworker checked even a couple of the "platinum" plans (which she couldn't afford even if they covered it) and it was not covered.

Lora