self pay follow up expense

[scalico 4]

So does anyone know if you are a self pay and you have to have additional surgery for a slipped band, does insurance cover any of that expense?

[Terry Poperszky 2,784]

I would imagine that is up to your particular insurance company.

[laurigee 545]

My insurance will not pay for any complications that arise from an elective surgery not covered under their plan! That is just my insurance, I'm sure there are some out there that possibly would????

[CBM7766 9]

I work for a health insurance company, in the authorization dept in fact. It totally depends on the plan. Also, please remember that your employer chooses the plan that you have. Customer Service should be most knowledgeable and I would hope, most helpful. It saddens me that there are plans out there that still deem this as elective surgery. :-(

[I love lucy lover 61]

I work for a health insurance company, in the authorization dept in fact. It totally depends on the plan. Also, please remember that your employer chooses the plan that you have. Customer Service should be most knowledgeable and I would hope, most helpful. It saddens me that there are plans out there that still deem this as elective surgery. :-(

Thank you for the sympathy, in fact I have Aetana and they did not cover it, I was a self pay. they said it was the plan my employer chose. What really kills me is they would rather pay for the side effects of high blood pressure, diabetes and all the other complications steming from obesity than at least help pay for lap band.

Im just saying makes no sense to me,. but what do I know im in the transportation business..lol

[CBM7766 9]

You are right, it doesn't make health sense. But it does make premium sense. If your company chooses not to cover elective surgery they will pay lower premiums. Sad but true. A lot of companies are on on board with keeping their employees healthy and offering programs that do so like charging those who smoke or have a high BMI more in premiums; enticing them to stop smoking or lose weight. By keeping their employees healthy, they go to the doctors less, resulting in fewer claims being submitted. Unfortunately, there are a lot of employers that choose to see the bottom line NOW rather than in the future health of their employees. Kudos to you for making this happen through self pay. I don't know if I would've been able to do it!

[I love lucy lover 61]

You are right, it doesn't make health sense. But it does make premium sense. If your company chooses not to cover elective surgery they will pay lower premiums. Sad but true. A lot of companies are on on board with keeping their employees healthy and offering programs that do so like charging those who smoke or have a high BMI more in premiums; enticing them to stop smoking or lose weight. By keeping their employees healthy, they go to the doctors less, resulting in fewer claims being submitted. Unfortunately, there are a lot of employers that choose to see the bottom line NOW rather than in the future health of their employees. Kudos to you for making this happen through self pay. I don't know if I would've been able to do it!

They do offer a "discount if you say your a non smoker and another one for health sceening and heath coaching.

Thank you, at true results they financed me. only got 5 months left then Im all done.

I believe if I had not done something I would have only gotten bigger and bigger

[Dream2BThinner99 2]

I work for a health insurance company' date=' in the authorization dept in fact. It totally depends on the plan. Also, please remember that your employer chooses the plan that you have. Customer Service should be most knowledgeable and I would hope, most helpful. It saddens me that there are plans out there that still deem this as elective surgery. :-([/quote']

I have Anthem BCBS and was told n the state of Missouri, Anthem (along with all of the other carriers in the marketplace, including United Healthcare, Coventry, and Aetna) exclude weight loss surgery. There are no plans available in the fully-insured small group market (under 100 employees) that will cover this surgery. This procedure is also excluded in the individual Missouri market, as well.