xxjosettexx 72 Posted August 24, 2014 I am looking into private healthcare companies that will cover bariatric surgery. I have found my surgeon, hospital, etc. I'm not looking to bargain hunt surgeons. I work at Dairy Queen part time, and am a full time college student. My employer does not offer any kind of insurance for employees, period. My parents are broke as a joke, so no help there. I am willing to pay the premiums that it takes for me to get surgery, but I don't want to take on a mound of debt this early in my life, and I DO NOT want to go to Mexico again, ever. Does anyone know of any individual health care plans/companies that will cover bariatric surgery? I am located in Oregon Thanks for any help! Share this post Link to post Share on other sites
Beth Pets 36 Posted August 24, 2014 Why don't you check out the Health Care Exchange at WWW.GOV. You sound like you are eligible for a help paying for your premiums and most Silver plans cover this. If you are low income the out of pocket and deductible is very low and in some cases zero. You may find that under Obama Care your surgery will be fully paid for. Share this post Link to post Share on other sites
Bufflehead 6,358 Posted August 24, 2014 It looks to me like Oregon is among the 26 states that do not require insurance policies offered via the Exchange to cover bariatric surgery. However, their in-state health coverage for needy folks, the Oregon Health Plan, does (or at least it did as of a few years ago) Since the OP is a college student only working part-time, perhaps she is eligible for the Oregon Health Plan? http://www.oregon.gov/oha/OHPR/EHB/docs/Final%20EHB%20Summary%20Presentation.pdf http://www.katu.com/news/local/126001408.html Share this post Link to post Share on other sites
xxjosettexx 72 Posted August 25, 2014 I will definitely look into both options that you guys mentioned! Right now, my care Oregon health insurance is covering a lap band removal due to major complications. I will look into OHP, because I know that it is different than Care Oregon, which is Medicaid. I was comparing coverage on the Cover Oregon website, and bariatric surgery was an exclusion under every network and plan level that I looked at :/ thanks for your help! Share this post Link to post Share on other sites
xxjosettexx 72 Posted August 25, 2014 I have read into the KATU story that you found, and my problem is that I have no comorbidities, therefore I'm not costing the state extra for diabetic supplies or oxygen tanks or sleep apnea machines, so my surgery is extremely low priority Share this post Link to post Share on other sites
auntiemel 275 Posted August 25, 2014 If you go to http://www.m.webmd.com/health-insurance/insurance-marketplace/default.htm you can check what is covered in each state. Oregon and Washington don't cover bariatric surgery with Obamacare. I will post more when I find the list of all the states that do Share this post Link to post Share on other sites
xxjosettexx 72 Posted August 25, 2014 Yeah, I don't want to have state healthcare anymore, I want to find a private insurance that will cover bariatric surgery Share this post Link to post Share on other sites
auntiemel 275 Posted August 25, 2014 Here it is http://www.healthpocket.com/healthcare-research/infostat/top-10-excluded-services-obamacare#.U_rWHdm9LCQ Scroll down and it shows all the states Share this post Link to post Share on other sites
auntiemel 275 Posted August 25, 2014 Yeah, I don't want to have state healthcare anymore, I want to find a private insurance that will cover bariatric surgery Premera or Aetna...but it costs quite a bit ???? About ten years ago my hubby and I paid for medical and it was over 300.00 a month for very basic coverage. I would hate to see how much it is now. Good luck and let us know what you find Share this post Link to post Share on other sites
pgerik 11 Posted August 25, 2014 Keep in mind that most, if not all, insurance companies will require coverage for a minimum of 12 months before covering wls, and even then you will have to pay the deductible + out of pocket up front. Share this post Link to post Share on other sites
xxjosettexx 72 Posted August 25, 2014 Yes I know this, I just need an insurance company that actually offers the possibility of me getting surgery. Right now, there is not even a remote chance that I will ever get surgery Share this post Link to post Share on other sites
larkspur 18 Posted August 25, 2014 I just did a search, and Moda Health appears to cover Gastric Bypass (not the sleeve and not the band). They require 6 months supervised weight management with a 5% loss, and they also require that you have a comorbidity. For BMIs > 40, degenerative joint disease with abnormal x-rays is considered a qualifying comorbidity, in addition to the standard ones like diabetes, high cholesterol, and sleep apnea. You might try calling them and asking! Share this post Link to post Share on other sites