Ineligible For New Health Insurance After Weight Loss Surgery?

[txdee 23]

I didn't put this in insurance category, because I thought it would get lost since most people are concerned about

insurance paying the surgery to begin with.

But what about after the surgery? What if you or your spouse loses or changes jobs so you have to change insurance companies or you apply from group to individual coverage or whatever. Anyway, I heard you are excluded from new health insurance coverage for 5 years, and that is only IF you lose weight and maintain that weight loss.

My insurance runs out 08/01/12.

Does anyone have any experience with this (esp. in Texas)?

[lizann85 4]

Let me start by saying I am not an expert in insurance. The following is just my opinion...

I have not heard of exclusions for insurance because of WLS. I believe each plan has its own requirements for eligibility. There are so many different plans out there that it would be difficult to make a blanket statement about eligibility requirements.

You could check with your state's regulating body of insurance (i.e. Dept. of Insurance) to find out if there are specific requirements and/or exclusions in your state.

[honk 780]

I didn't put this in insurance category' date=' because I thought it would get lost since most people are concerned about

insurance paying the surgery to begin with.

But what about after the surgery? What if you or your spouse loses or changes jobs so you have to change insurance companies or you apply from group to individual coverage or whatever. Anyway, I heard you are excluded from new health insurance coverage for 5 years, and that is only IF you lose weight and maintain that weight loss.

My insurance runs out 08/01/12.

Does anyone have any experience with this (esp. in Texas)?[/quote']

I had to go to the high risk pool for health ins for my state because I needed independent insurance. I was not getting it through my employer when COBRA ran out. At the time I was told surgery was considered a pre existing condition for 1 yr. I called recently and was told I had to be 215 lb or less for Bmi req. I am 2 lb away. I don't think LB is an issue if you change from one employers health ins to another. Though no guarantee they cover fills.

[NWgirl 574]

For employer covered insurance, they have to cover you regardless. They may stipulate that they won't pay for any WLS related care though. If you're going to buy private insurance, some can deny based on WLS.

[auntielle 42]

I live in Texas & have been in the high risk pool for a few years b/c I'm self-employed & have had major depression for years. No one would take me b/c I was taking too many meds for that. I'm now only taking two so I called an agent the other day. I told her I had lap band surgery last Sept. She checked & said I was declined by both companies b/c I had wls even though I was self-pay. However, she said one of them said they would take me after a year. I'm hoping to be at or near goal by then so hopefully I can change. So far I'm down about 75lbs., no problems, feel great! I would have the surgery all over again, regardless.

Good luck!

[cjane 0]

I was denied coverage(self pay, no group) BECAUSE I had had WLS. I was told that it's automatic for most companies, but some will cover you after 3-5 years.