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Need Opinions on who are the best insurance companies to cover the Lap-Band...



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Hi everyone....

Okay, since starting my little venture, I had decided to be a self pay patient, but am having a different view. Not to say that I won't end up being a self pay patient, so here's the deal. My DH's company insurance does not cover the band at all, heck, they don't even cover the bypass.

Well, what I am thinking about doing so that I can get this covered is have my husband drop me from his insurance which is not cheap anyway, and have a different insurance pick me up. I have priced the different ones out there, and they end up being a little bit cheaper than my current insurance. For example, UHC doesn't necessarily say its covered, but doesn't say that its not, so therefore, I need some imput. Who is the best insurance company out there in ya'lls opinions for me to choose and do ya'll think this is a good idea?

It ends up costing me more or less the same premium every month, so I will not have to spend that extra money out of my pocket for the self pay issue. I am open to suggestions and comments, if anyone knows, that would be great! Thanks...

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You might want to join the Yahoo group:bandstersinsurance It's all about insurance and being banded.

But remember, your policy may be very different from mine, even though we may both have the same insurance company because of exclusions and riders.

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And use the search function here and look up UHC, I've read some nightmares about them, and others where it's been totally excluded.

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Hi,

I have bc/bs and I was approved in about two weeks. I have a friend who also has but he's been trying to et approved for months. bc/bs had my medication history and I think that is why they were happy to get me approved. It all depends on the policy and exclusions, ask many questions before signing up. Good luck!

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I have Aetna and a BMI of 40 with no co-morbities, and was approved with no problem, all I had to do was go to a nutrition class once a week for 3 months that was provided by my Dr. To my surprise I had no troubles at all. I am to be banded April 4th.

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Federal Employee Health Benefits have to cover WLS by Federal Law starting in 2007. They may make you jump thru hoops, but they HAVE to cover it!

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I found out that my ins. company will only pay a whopping $3800! Not much when you consider the total cost of the procedure. I'm disappointed. BTW, can anyone tell me about the psychogical part? I have had depression and take medication for it, so everything is ok. The shrink part just makes me nervous.

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Usually, if you go to a bariatric surgeon, they will already know what your insurance will or will not cover. I would go for an initial consult and see what they say... they've been through it all before.

Best of luck!

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Hi everyone....

Okay, since starting my little venture, I had decided to be a self pay patient, but am having a different view. Not to say that I won't end up being a self pay patient, so here's the deal. My DH's company insurance does not cover the band at all, heck, they don't even cover the bypass.

Well, what I am thinking about doing so that I can get this covered is have my husband drop me from his insurance which is not cheap anyway, and have a different insurance pick me up. I have priced the different ones out there, and they end up being a little bit cheaper than my current insurance. For example, UHC doesn't necessarily say its covered, but doesn't say that its not, so therefore, I need some imput. Who is the best insurance company out there in ya'lls opinions for me to choose and do ya'll think this is a good idea?

It ends up costing me more or less the same premium every month, so I will not have to spend that extra money out of my pocket for the self pay issue. I am open to suggestions and comments, if anyone knows, that would be great! Thanks...

I had UHC, choice plus. Now, I know others had this insurance as well and they were not covered, it depends on the policy that was written for the employer, some employers opt to have an exclusion for WLS, therefore, costing them less money for premiums.

But, my company did not have any exclusions, so I was covered. I called UHC, the only thing I had to have was a BMI of 40. I went to the doctor on 11/22/06, not sure when them submitted my paperwork, but I assume within a week. I was approved on 12/04/06. I had my surgery on 1/18/07. I've paid right at $1000 out of pocket expense for my surgery, doc and all my appointments. I'm very grateful to have the insurance because I don't think I could have paid for it out of pocket.

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    • BabySpoons

      Sometimes reading the posts here make me wonder if some people just weren't mentally ready for WLS and needed more time with the bariatric team psychiatrist. Complaining about the limited drink/food choices early on... blah..blah...blah. The living to eat mentality really needs to go and be replaced with eating to live. JS
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        We have to remember that everyone moves at their own pace. For some it may be harder to adjust, people may have other factors at play that feed into the unhealthy relationship with food e.g. eating disorders, trauma. I'd hope those who you are referring to address this outside of this forum, with a professional.


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        Seems it would be more compassionate not to perform a WLS on someone until they are mentally ready for it. Unless of course they are on death's door...

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