Need Insurance Advice PLEASE!

[wisaluv 0]

I have United Healthcare and they do not cover weight loss surgeries.

I have decided to try and get an individual health insurance plan but I dont know who will cover it? Please let me know which companies are the easiest to get approved by. Besides medicaid, I dont qualify.

[jalivia2 0]

I don't know what state you're in, but I received my approval from BCBS of TX is 2 days. However, they do require that you have coverage with them for 2 years before they will cover any WLS.

[malinda1229 1]

I work for a company that sells health insurance so I knhow a little about this. United Health does cover the surgery...your PLAN does not. ALL health insurers have different plans with in them. For example I had United Health in 2009 and started this process, called and I WAS covered. I switched employers at the end of 2009 stayed with United Health but was now under a different plan that DOES not cover it.

Got married went on my husbands Blue Cross they would cover the surgery but not with my out of state dr I had to find a Dr in RI. Blue Cross has 24 major health plans in RI then MANY other health plans for large employers.

Bottom line its not the insurer but rather the plan you pick that can dictate if costs are covered.

So before you go and switch see if your employer offers different plans within United (some large employers offer many options for the same carrier) before you head off and purchase individual coverage.

BTW i may be less expensive for you to pay out right for the surgey than by an individual plan AND you may not even qualify as you will need to apply and they MAY want to see your med records.

[kagead 0]

I have an individual policy with Blue Cross Blue Shield of IL and my surgery was covered. BUT, I recall reading posts here about others who had individual BCBS policies in other states and they were NOT covered.

The best thing you can do is figure out which private policies are available to you in your state of residence and go to each of them individually.

FWIW- my BCBSIL policy did not require me to be with them for any period of time before they would cover the procedure. They have a 3 month supervised diet requirement (among others). The psych evaluation was covered at 50% and none of the nutritionist services were covered at all (2 private sessions and 4 classes.)

I have a $250 deductible and a 20% coinsurance payment for most procedures. My maximum out of pocket per year is $3,000.

All told, I think I will end up spending between $3,000 and $5,000 out of pocket for everything involved with the surgery and that is with one of the best individual policies they offer.

HTH-

kagead

[apimen82 0]

Unfortunately, I am in the same boat as you. I also have United and the plans offered by my employer do not cover WLS. I've been doing a lot of research, attended a few seminars, and was really excited about possibly doing this procedure, and now I feel devastated. I simply can't afford an additional loan right now, but I'm so depressed about my weight, I even contemplated doing it out of the country, but honestly that sounds just as scary to me. I guess I will have to wait til I can afford the surgery on my own. If you come accross any other option, please let me know.