Insurance Trick - Individual Plan

[lapnicky 39]

Back last summery insurance denied my Lap revision because there was an exclusion on Bariatric surgery. So friggin nice of them since my band was making me throw up unfilled. Totally frustrated my doc's insurance gal told me a great suggestion. Opt out if my employer's insurance plan and buy an individual plan on my own like Blue Cross who covers weight loss surgeries. I did it and with the new non pre existing clause they couldn't say no due to my prior Lap Band. Jan 1 my new insurance plan was effective and on Jan 14th my revision was approved. Feb 10th is my big day!!! I would have never thought about totally thinking outside of the box with playing this insurance trick without my doc's creative insurance gal. I thought my dreams of a revision was gone until she told me what to do. I owe it all to her! ????????????????

[McButterpants 2,846]

Wow - great news for you!

Congrats.

[SandeeD 363]

YAY FOR YOU!!!!! YOU GIVE ME HOPE. I TOO HAVE HORIZON BCBS NJ, AND SWITCHED OVER FROM ONE OF THEIR OLD PLANS TO A NEW ONE (THAT HAS NO EXCLUSIONS OF PRE-EXISTING ILLNESSES). I SPOKE TO THEM TODAY AND THEY SAID I WILL HAVE AN ANSWER THE MIDDLE OF NEXT WEEK, BUT THE WAITING IS SHEER TORTURE !!!!!

Back last summery insurance denied my Lap revision because there was an exclusion on Bariatric surgery. So friggin nice of them since my band was making me throw up unfilled. Totally frustrated my doc's insurance gal told me a great suggestion. Opt out if my employer's insurance plan and buy an individual plan on my own like Blue Cross who covers weight loss surgeries. I did it and with the new non pre existing clause they couldn't say no due to my prior Lap Band. Jan 1 my new insurance plan was effective and on Jan 14th my revision was approved. Feb 10th is my big day!!! I would have never thought about totally thinking outside of the box with playing this insurance trick without my doc's creative insurance gal. I thought my dreams of a revision was gone until she told me what to do. I owe it all to her!

[lapnicky 39]

Hang in there SandeeD!! I cried with sheer joy and relief when they gave approval.

[AuntieLala83 81]

Back last summery insurance denied my Lap revision because there was an exclusion on Bariatric surgery. So friggin nice of them since my band was making me throw up unfilled. Totally frustrated my doc's insurance gal told me a great suggestion. Opt out if my employer's insurance plan and buy an individual plan on my own like Blue Cross who covers weight loss surgeries. I did it and with the new non pre existing clause they couldn't say no due to my prior Lap Band. Jan 1 my new insurance plan was effective and on Jan 14th my revision was approved. Feb 10th is my big day!!! I would have never thought about totally thinking outside of the box with playing this insurance trick without my doc's creative insurance gal. I thought my dreams of a revision was gone until she told me what to do. I owe it all to her! dde04dde04dde04dde04

Lapnicky,

That's what I did too. Purchased Healthnet PPO effective Jan 1, papers submitted Jan 10, approval Jan 16 and surgery will be Feb 10.... So happy to get this band out and sleeve in

[NYCGIRL 5]

With these insurances you pay per month? Is it a contract? My insurance is Medicaid so I'm not familiar but am considering switching or getting an addition insurance for my revision.

[mgolden1984 13]

That's a good idea. I might do the same if my revision is denied

[sleeve30 33]

I just purchased a new individual plan. Let's see how it goes ... It's effective April 1st.

[lapnicky 39]

I just purchased a new individual plan. Let's see how it goes ... It's effective April 1st.

Awesome! Before you purchased the plan did you find out if the plan covers bariatrics?

[sleeve30 33]

Yes, I called Horizon BCBS NJ and they told it is covered...it also says it on the benefits covered.

I just hope Im lucky like you lol

[SandeeD 363]

Hey there! I posted on here on 1/23/14. I'm now 4 weeks post op from sleeve surgery and 25 pounds lost so far. Horizon Blue Cross Blue Shield NJ was the insurance that I purchased and they gave a quick approval. Keep the faith and keep pushing.

[sleeve30 33]

Hey there! I posted on here on 1/23/14. I'm now 4 weeks post op from sleeve surgery and 25 pounds lost so far. Horizon Blue Cross Blue Shield NJ was the insurance that I purchased and they gave a quick approval. Keep the faith and keep pushing.

Oh wow awesome!!! I purchased BCBS NJ too which plan you got?

So awesome!!! 25lbs already!!! Ahhh who was your surgeon?

[SandeeD 363]

I'm in South Jersey. My doctor was Dr. Christopher Boynton in Lumberton, NJ (Burlington County). My insurance is Advantage EPO Silver. My premium is $549 per month, but I'm sure there are other plans that cover bariatric surgery that are cheaper. Take a look at www.ehealthinsurance.com. I hope this helps!

[Susysleever 265]

When I worked at Cigna (horrible job btw) I learned about Out Of Network benefits. They paid 80/20 on non cigna providers. Also paid for tube feelings and atypical therapies. Again, they don't want you to know.

[sleeve30 33]

I'm in South Jersey. My doctor was Dr. Christopher Boynton in Lumberton, NJ (Burlington County). My insurance is Advantage EPO Silver. My premium is $549 per month, but I'm sure there are other plans that cover bariatric surgery that are cheaper. Take a look at www.ehealthinsurance.com. I hope this helps!

Oh ok I'm in Central Jersey.. Considering Dr. Abkin... I purchased mine through ehealth too I chose Advance EPO $393 per month. Any issues with paperwork?

Edited March 26, 2014 by sleeve30