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PacifiCare Sucks!



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Don't you find it just amazing that some insurance companies are helpful in getting this surgery for you and others are not, especially since losing weight is supposed to be the cure-all for so many ailments? The really amazing thing I found out about PacifiCare is that their PPO plan will not cover it, only their HMO plan.... now why would that be?? Makes NO sense! :) !

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It all about CARVE OUTS. An insurance company may offer it to a company and the company chooses a cheaper plan based on what is "carved out". just because an insurance company covers it in some doesnt mean they do for all. Its all up to what the employer is paying for and saving money on. Everyone curses the insurance company- its not their problem. Its what the company chooses to cover or not!

Think of it as a turkey. The turkey cost is $20 per person if you carve off the breasts(WLS, PS, other $$$ procedures) then the cost comes down to $8 perperson that is more affordable for the company and the majority of the employees. THAT is how insurance for companies and employees is dealth with.

Hope that helps- its not personal its business. The people are not factored in except for how many in numbers need health insurance. sooo if you want it covered you have to go to the personel/human resources and that will be a fight of fights as you will find. If they make an exception for you they have to do it for everyone. Silence is never kept and they end up losing $$$$.

Good Luck!

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Thank you for the explanation! How do you know all that?? You certainly made it understandable! I guess in a perfect world, all helpful surgery would be covered by every insurance, but since this world is NOT..... sigh... OK, I will try to be patient and understanding! Thanks for your help...

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