underinsured - not sure what to do

tentacularone
on 4/29/08 9:09 am - Evansville, IN
I have a PPO with Aetna, and before I can even get to the details of what all I have to do to qualify, my provider says they have a lifetime maximum of 10K coverage for bariatric surgery. In my area it costs around 35K, so that isn't really very helpful. Is there a way for me to go about buying more insurance or getting help some other way? I don't even know where to start.
Vicki Browning
on 4/30/08 11:44 am - IN
Is this insurance through your employer?   Going out and taking out another insurance policy to supplement your current, may be challenging because you will have to go through underwriting and probably have to pay a higher premium if approved because of your obesity so you would have to weigh the pros and cons paying extra premiums per month vs paying out right the difference that Aetna does not allow.  
tentacularone
on 4/30/08 11:24 pm - Evansville, IN
Well, since it will be quite a while for me to save up 25K, I would probably take any insurance whose premiums I could afford. As the guru, do you recommend any particular private firms?
Vicki Browning
on 5/1/08 1:49 am - IN
To tell you the truth I know of none that will write a individual policy that includes WLS.   Most individual policies exclude WLS because of cost containment.   I would suggest you find a insurance broker that deals with many insurance companies to see if they may know of any that provide individual coverage that includes WLS. 
tentacularone
on 5/1/08 12:10 am - Evansville, IN
Also, is there any detriment to filling out lots of estimate forms and getting quotes from everywhere?
shannon C.
on 7/21/08 9:29 am - Las Vegas, NV
Try not to go buy the maximum covered amount and the real cost of surgery.  My insurance has a Max covereage amount of 7500 and the Lap RNY Costs 25,000 here.  My out of pocket was only 1500.  Doctors have "contracted rates" with insurance companies which are 100% of the time much lower then the actual cost of surgery and they are prepared and always "write off" a certain amount of the cost because of these contracted rates.  Look into that!!!
tentacularone
on 8/24/08 5:29 am - Evansville, IN
Thanks. So how do you get places to admit to this practice, and is there any way to find out before hand what the actual costs may be? When I talked to the financing person at the surgery center, they basically asked if I had the $15000 difference, and when I said 'no' they basically said I was SOL.
(deactivated member)
on 9/14/08 12:43 pm
From what I've heard, Starbucks part time has insurance that covers WLS.
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