Insurance WLS Exclusion

[condanchri 16]

Hi there - I'm worrying if anyone has had success in attaining WLS, when your insurance policy has a WLS exclusion put in place by the employer. My husband (and I) have excellent insurance through Aetna, but his employer has placed a bariatric surgery exclusion on the policy. I have spoken with Aetna, and they say no way, unless it's a'life or death' situation. Any information would be very helpful.

Thanks

[ShoeLover 141]

I have Aetna, and my employer has an exclusion as well. You may be able to appeal with your employer, but usually when it is an exclusion they don't approve it. That's why I used my FSA to have my surgery in Mexico.

[condanchri 16]

Thanks shoe lover, that's what I thought, but wanted to make sure. Mexico is looking more and more like my reality.

[LezzieLez 180]

I went to the benefits administrator and said to add bariatric surgery back onto our insurance, it would increase everyone's rates - which employees are already pissed about the increase we just had.

So, Mexico it is..

[condanchri 16]

YRaj, that's what I was thinking, too. My husband's a cop, and any WLS would probably only benefit such a few spouses, they wouldn't want to increase rates. Thanks!

[mcwestfam 123]

My policy excludes wls too. That's why I ended up going to Mexico. There is sometimes a partial way around it if you happen to have a hiatal hernia with reflux. Your insurance will pay for that. And then you pay out of pocket for the sleeve portion. Which Tends to be much less.

[Magnolia85 0]

Im having the same issue with BCBS AL. Hubby is against going to Mexico. Just wanted to chime in and say you are not alone in the struggle.

[condanchri 16]

Thanks for the support Magnolia. I'm thinking Mexico at this point. I have an appointment with my PCP tomorrow - she's agreed to see me for follow up care, unless there are complications. I had a lap band put in in Mexico in 2004 (and removed in 2008), and besides the fact that the band was ultimately not a good solution for me, I felt comfortable in Mexico. I'm sorry you're in the"insurance exclusion boat," too.

[lucky8mb1 167]

Mine excludes it completely, and there was no way to get it added. So I ended up self-paying with a local surgeon.