Uninsurable After Surgery?

[GrammyK 11]

Hi! I just heard this rumor that after we have this surgery, we are uninsurable for 5 years, if you try to move to a different insurance company than the one you have now. My friend who had the sleeve done 2 days after I did was thinking of quiting her job where she now gets her insurance thru until she heard that no insurance company will pick her up because she had the sleeve. Anyone else hear or know about this?

[Tiffany Talbert Corbet 46]

Sounds kinda odd since many of the insurance companies are jumping on board to cover it for their patients. I would think they would happily cover her since it will be an indication of fewer health issues in the future, thus lower costs for them in the long run, and they can make money off of her premiums with fewer claims coming their way.

I would find out who she heard that from, and do some calling around to different insurance companies and ask. (But I highly doubt this is the case.) Plus, it would boarder on discrimination (IMO) because it's not a pre-existing condition (again, IMO).

[Rootman 1,101]

There is no answer to this question, it depends on the company and their insurance carrier.

It would all be according to how strict the new company wants to enforce their per-existing conditions clauses in their policies. Some might not want to pick up the insurance at all and others may just refuse to cover anything that they might think is remotely due to bariatric surgery.

It's really the same for ANY major surgery.

[IsB 209]

Haven't heard it but it sounds like an urban legend to me. Companies changes insurance providers all the time. In the past 10 years I've had 6 different ones and that's staying in the same job. We've had lots of employees with different issues and I've never heard on anyone being excluded from the insurance plan when we switched.

Like anything else you just want to make sure there is no lapse in your insurance so you don't end up with a pre-existing condition that is excluded.

[Back~To~Amy 307]

Rootman is exactly right about this. And, pre-ex clause times vary. Most are only 1 to 2 years and not 5.

[Marty McSkinnystein 342]

I did research on this and I think it's due to other surgeries sometimes having complications and weight gain after a few years. Most things I read said if you're part of a group (like at work) you're fine but the self insurance is hard to get. I agree about it being prejudicial for the same reasons.

I wonder if we worded it "partial gastrectomy" (such as people with a large ulcer or stomach cancer might get) if that sounds better- just not saying the words WLS. Essentially that's what it is- right? partial gastrectomy (removal of part of stomach). If asked directly, legally you have to say weight loss surgery, but that might be the way around it.

[SV2 57]

The Affordable Health Care Act outlawed denials by insurance companies for pre-existing conditions.

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[Marty McSkinnystein 342]

The Affordable Health Care Act outlawed denials by insurance companies for pre-existing conditions.

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Then why do I read so many saying they couldn't get insurance and the reason was stated about WLS? And these are "reputable" companies. Are they breaking the law?

[Alithinos 19]

The Affordable Health Care Act ("Obamacare") just recently went into effect. I would agree with SV2 - the law would prohibit insurance companies from not covering you, and I believe there is a limit to how much they can charge you as well.

The link provides more information regarding pre-existing condition insurance:

http://www.healthcare.gov/law/features/choices/pre-existing-condition-insurance-plan/index.html

[GrammyK 11]

Thanks for all the replys. It does seem strange that an insurance wouldn't pick you up because of this surgery. After all, we are all getting healthy and in the long run, it will cost the insurance companies a lot less to carry us. This is why we are all going to this extreme to get healthy!!