What's The Better Insurance?

[hernandez.amie 0]

Called my current insurance yesterday pertaining to the VSG surgery, they don't cover it. I need to call again just to make sure. It could be because my insurance is through my employer. Which I found weird... my boss has had two open heart surgeries with the same insurance since I've been there, and it was covered... I don't see why this won't be...

I've found some decent monthly premiums that I can pay on my own (and not have insurance through my job), but how exactly do I know if the surgery is covered? And what insurance is better?

Thanks!

#notgivingup

[woo woo 872]

Some insurance policies do not cover WLS under any circumstances, and others will only cover certain procedures.

If your employer's insurance specifically excludes WLS there is no way they will cover it. Open heart surgery is something completely different (obvi).

As far as getting your own insurance outside of work, you would have to read the fine print and call and ask specifically if WLS would be covered I suppose. I will say that it is normally quite a bit more expensive to carry your own policy because employer policies are partially paid by the employer with only a small portion paid by each employee (the part taken out of your check). You also might be getting less coverage with your own policy, especially if the premiums seem low.

AND... there is Obamacare to consider. Check to see if WLS is covered in your state under Obamacare. There is a spreadsheet with that information floating around somewhere.

Also, don't forget about selfpay! There are some really excellent options in Mexico and within the USA. Good luck!

[hernandez.amie 0]

Called my insurance again, no go. My employer doesn't cover anything.

My only bet would be to get another insurance... because self-pay is not possible for me.

#frustrated

[Truckerchic 171]

Called my insurance again, no go. My employer doesn't cover anything.

My only bet would be to get another insurance... because self-pay is not possible for me.

#frustrated

My hubby and I tried to get our own insurance just for the purpose of getting me the surgery....when doing it on your own you have to fill out health questions ...we got turned down because he smokes and my bmi was to high..go figure..3 years later our employer switched in new insurance and thankfully it was covered! Good luck

[hernandez.amie 0]

Called BCBS of FL, and Golden Rule of UHC... they don't cover it... whaaat?

[Comfy_Blue 285]

Cafe First BCBS has been amazing. My friend lives in VA and was able to get her lapband in about a month and a half because they don't require much, just that you have a bmi over 40 and do a psych exam. I have the same insurance, but for Maryland. I was required to have a BMI over 40, do a sleep study, psych exam, have 6 months of a structured weight loss program prior to asking for surgery (weight watchers) and an endoscopy. I started the process in late October. My surgery was approved and is now scheduled for Dec. 23.