Morbid Obesity Surgery Exclusion ... Is there anything I can do?

Icomputeit
on 8/11/13 9:02 am

I reviewed my healthy insurance policy from BCBS today and it has a Morbid Obesity  Surgery exclusion.  I did not realize this until today.  I have an appt with my surgeon in a couple weeks to discussion options for a revision.  I was thinking they covered WLS surgery as they use to but now it appears my employer does not.  Any ideas,can surgeons office submit paperwork to see if they would override or is that out of the question?

Member Services
on 8/11/13 9:37 am - Irvine, CA

Be sure and speak to your surgeon's office about your options. Also please post this question on our Insurance, Cash Pay and Financing for WLS Forum too.

TamaraL
on 8/11/13 11:06 am

Each employer can choose to have the morbid obesity surgery "RIDER". the employer is the only one that can change this.

 

Do you have other insurance options?



 

Sherrie P.
on 8/11/13 11:54 am
RNY on 02/06/13

Doubtful - that is what exclusions are for.

I was banded in Mexico and would have gone to Mexico for revision to the sleeve if my insurance had not paid for the revision.

Best of luck to you.

Getting rid of the Crapband was the best decision ever...

Revision Lapband to RNY 2-6-2013   HW: 286  Pre-Op Diet: 277  Surgery Day: 265  Goal: 155  CW: 155

Plastic surgery 8/28/2014: Brachioplasty, mastopexy, & abdominoplasty.

Plastic surgery 1/27/2015: Butt Lift

    

airbender
on 8/11/13 1:03 pm

unfortunately i see this more and more every day.  an exclusion is just that, exluded in coverage.  can you get a different coverage?  sometimes companies offer multiple policies, they may be different, check them all.  if you have a spouse check that policy.  a surgeon has nothing to do with your policy, it is between you and your insurance co, not surgeon.  if you are asking about appealing, an exclusion is pretty iron clad....that is why everyone should get a copy of , read and know their subscriber agreement, not just for this example, but for all of our healthcare needs...good luck to you...

(deactivated member)
on 8/11/13 2:03 pm

Sadly, no.  Ins co's require additional premiums for WLS and if they aren't paid they have no reason to cover any WLS let alone a revision.  It's really quite expensive for this rider and with the economy being what it is most employers do not pay the additional premiums.  Most ins co's are also going to a once in a lifetime WLS even if they do cover bariatrics.  Doesn't matter in the least who paid for the original surgery, even if it was self pay that was your once in a lifetime WLS.

Sorry.

Icomputeit
on 8/11/13 10:19 pm

Thanks everyone for taking the time to respond.  I do appreciate the information and your thoughts on this.  

Best to all!

Most Active
Recent Topics
×