Insurance for the Uninsurable

[crosswind 134]

So here is what I found out about getting insured after the VSG. If you are a self-pay patient because you can not get approved by your regular carrier, or because you have no insurance at this time ( possibly because your BMI is too high) -- then your next option is federal or state PCIP insurance.

I am posting this here because even if you have health insurance now, there might come a time later when you lose your job or want to apply for private individual insurance and are denied because the VSG makes you UNINSURABLE. According to the rep at BCBS the surgery needs to be two years old with no complcations in order for them to write a policy. According to AETNA, you may not apply for six weeks after surgery and if complications arise, you are considered uninsurable. According to United Healthcare, you may not have had any bariatric surgery for five years, with no complications.

So in the case that you are truly SOL, Obama's Affordable Insurance Act created an opt-in program for all states to provide low-premium affordable health insurance. Information about that is here:

http://www.healthcare.gov/law/provisions/preexisting/index.html

You can apply immediately and electronically at this link if your state participates in the federal coverage enacted by this law:

https://www.pcip.gov/Apply.html

There is no waiting period.

If your state does not participate in federal PCIP hen they have created their own affordable healthcare state option. Information about your state's PCIP can be found at the top link.

[Day Dreamer 23]

This is good information. Thank you for posting. One thing I want to add for self pays is to check for a surgeon that is certified through BLIS. Surgeons with very low complication rates are generally certified through BLIS. BLIScare offers a complication insurance coverage that can protect you if complications arise. It is a good investment for those that know they will not have any coverage otherwise.

BLIS http://www.bliscompany.com/programs-and-services/bliscare-complication-insurance.html

Also, if you get insurance through an employer (group insurance) you cannot be turned down. It is the private insurances that can deny you if you have had any WLS or complications.

Good luck to all.

[former_vbg 198]

This is good information. Thank you for posting. One thing I want to add for self pays is to check for a surgeon that is certified through BLIS. Surgeons with very low complication rates are generally certified through BLIS. BLIScare offers a complication insurance coverage that can protect you if complications arise. It is a good investment for those that know they will not have any coverage otherwise.

BLIS http://www.bliscompa...-insurance.html

Also, if you get insurance through an employer (group insurance) you cannot be turned down. It is the private insurances that can deny you if you have had any WLS or complications.

Good luck to all.

I am fortunate that I have insurance through my employer and wouldn't have a need for this- but it is good to know that something like this does exist. I went to the link and was rather disappointed though. There is no contact information to apply, no way to find out if a surgeon is on their list, really very lacking in a lot of information I would have expected to see there.

How does someone apply if there is no contact information or information on how to apply?

[Lakelady 2]

Thanks so much for bring this up! I work for myself and have gambled (and won) for the last few years and haven't had health insurance coverage. I didn't think about health insurance much before my surgery but now I'm getting my life in order. I applied for a high deductible health insurance for me and the kids through BCBS and was denied. Naively I thought I'd be able to get it because I weighed 30lbs less! I'll probably just get a high deductible policy for the kids and base my next application on the advice here. This place is great. I'm having NO COMPLICATIONS to I think I'll be just fine.

[mrsnate 55]

This is kind of an old post so I'm not sure anyone will see it, but I wanted to say that PCIP is who my insurance is through. I found my information on healthcare.gov. I'm in Arizona and was able to get covered for a very reasonable price. I was turned down for a "standard/normal" insurance policy due to pcos.

[dzrving 0]

I applied for insurance in PA under Obama’s Affordable Healthcare Act for people with preexisting illness and was approved within 4 weeks. The cost is 283.00 a month, income is not a factor and it is VERY good insurance. One of my preexisting was overweight, also high blood pressure. I had not had insurance coverage in about 4 years. Once I was approved I had a FULL check-up and found I had diabetes. I went to bariatric surgeon and started testing and preparing for weight loss surgery however the insurance co denied my request stating “not covered under the plan” but they will cover any medical cost that you may incur after WLS!! ? . PA (PA fair care)goes with their own insurance co. Many states provide insurance under the Affordable Healthcare Act that WILL cover bariatric surgery. I am grateful that I was able to get health insurance, but disappointed about the WLS. However after much research I decided to go to Mexico for my surgery.