Anyone had luck with insurance covering some/all of surgery?

[Scornelius 0]

I called my insurance company today (Great West Life) and was told that while they don't generally cover the lap-band surgery, if my doctor sends in an estimate along with reasons the surgery is needed they will consider it. Has anyone had any luck with something like this? Is there any way to get the insurance company to pay for any of it at all? I'm 24, and my BMI is 48.

Thanks!

[susansilver 0]

I called my insurance company today (Great West Life) and was told that while they don't generally cover the lap-band surgery, if my doctor sends in an estimate along with reasons the surgery is needed they will consider it. Has anyone had any luck with something like this? Is there any way to get the insurance company to pay for any of it at all? I'm 24, and my BMI is 48.

Thanks!

Let me know what they say- I am also with Great West and had not even thought of asking them. Are you in Toronto?

Susan

[Scornelius 0]

Close, we live just east of Toronto, in Pickering. Are you nearby?

[Gaffer 1]

In 2004, PacifiCare policy specifically covered nearly ALL the Band surgery and most of the preliminary work-ups....

The last 2 years, Band surgery has NOT been included in their policy.....

Careful reading of WHAT your policy will specify WHAT is covered, to what degree....and what is NOT....

Remember, the CHOICE of WHICH surgery is up to YOU and the surgeon. The choice what the carrier will pay, is up to the policy definitions stated in your specific policy.

Mine tried to herd me into doing RnY but medical reasons eliminated that particular approach.

Good luck, keep us posted.

Canadian health insurance tends to be a lot different from American, as we have univeral heath care here, and the surgery is not covered by many Provinces, and tough to get it if your province does cover it.

To Scornelius, I am going to try and submit some of my claim to my health insurance (AB Blue Cross), but I am not too hopeful. Both my wife & I have health spending accounts so I might me able to get some money out of them there for my Optifast and maybe consults or fills. For me though, I think it would be only about $700.00 tops.

I guess there is no harm in trying, but I am doubtful that you benefits will cover it.

Andrew

[susansilver 0]

You are probably right Andrew.

Scornelius - I live in downtown Toronto. Where are you being banded?

[Scornelius 0]

To Andrew: Thanks for the info. It's too bad there's so little to get back! I really can't believe how stubborn OHIP and the private insurance companies are being.

To susansilver: I haven't chosen a place yet. A lot of that depends on whether by staying in Canada I can get any of it paid for by insurance. Otherwise, I'm sincerely considering Mexico. At nearly half the price, it's a far more realistic idea, I think. And I've heard some really good things about Dr Ortiz.

Sonia

[Gaffer 1]

To Andrew: Thanks for the info. It's too bad there's so little to get back! I really can't believe how stubborn OHIP and the private insurance companies are being.

It is unfortunate, and really I think that they could save the systew much more money through preventions like the lapband, but that is not what health care is about in Canada.

It frustrates me that within my own health insurance I can claim stop smoking programs, and I would be able to get help if I was anorexic but they will not cover programs aimed at helping people lose weight. This despite the fact that obesity will soon beat out smoking as a leading cause of death.

I do consider myself lucky that I am able to get some back from Alberta Heath, about 1000.00, but that is a drop in the bucket for the $16K plus that this cost me.

Dont forget that it is also tax deducatble so that helps also.

Knowing what I know now, it is worth the money, and if I did not have the means I would beg, borrow and steal to get it.

Andrew

[Heldie 0]

Good Evening Folks,

I was told at our information session when I first visited TLBC that we could deduct the cost of the procedure on our tax returns. I plan on trying it for next year!

[Gaffer 1]

Good Evening Folks,

I was told at our information session when I first visited TLBC that we could deduct the cost of the procedure on our tax returns. I plan on trying it for next year!

Yes you are able to deduct it in your tax return as a medical expense. I also plan on deducting things like my flights to get there and my hotel stay while I was there, but I will double check with my accountant.

All you need is a copy of the receipts for your records should the CRA want to see them.

I also think that you are able to carry those expenses forward to be used in a future year if you dont want to claim them in the year that the were incurred. I will have to do some careful palnning to get the maximum tax benefit from this.

Andrew

[msrobby73 0]

I did our Incime tax and for us it made about $3000 difference. I included cost of surgery, flight x3(intital surgery and fills) and the hotel stay after surgery- i forgot to get receipts for the taxi rides. Too bad we dont get the whole amount back but for us $3000 back is better than nothing.

Robyn

[msrobby73 0]

My hubby had GWL and I inquired about covering LapBand and was told NO. Which is STUPID!!! LOLOL

Robyn

[Tagger 0]

Just wondering...can you only claim it if you had your surgery in Canada or can you claim it if you went to Mexico?

[lambchops 0]

Hello all. I have Sun Life insurance and they paid about $3000 for surgeons fees etc, but not for the band. It is now under appeal with the insurance company, but who knows what will happen there.

[Gaffer 1]

Hello all. I have Sun Life insurance and they paid about $3000 for surgeons fees etc, but not for the band. It is now under appeal with the insurance company, but who knows what will happen there.

Very Interesting. At least you got the $3k. Maybe I will submit a Blue Cross claim and fight like hell. I think I have a couple thousand dollars of fight in me.

Andrew

[lambchops 0]

Andrew,

You may wish to ask Dr. Cobourn for an itemized bill. The ins. co. requested that so they could see what they could cover. Anesthesia was also covered.

I am having trouble getting the spell check to work. I have downloaded it, but it is still not working. Any suggestions from anyone?