Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Obtaining New Health Insurance After Lap Band



Recommended Posts

I know I've seen references to this in other threads, but of course I can't find them now. I'm going to be looking for new health insurance, individual plan. What is the general rule as far as whether I am insurable, bumps in premiums, and what exclusions to expect having had the surgery?

Share this post


Link to post
Share on other sites

This is an old thread, but I'm going to give it a bump because I am curious about the answer too! I worry about having to switch insurances one day, what coverage will be like..

Share this post


Link to post
Share on other sites

First and most important: There is no "general" rule because it's the STATES who regulate insurance, and every state has its own rules. The ONLY things that are the same nationally are those items that fall under Federal regulation (HIPAA). Under HIPAA, you can't be socked with a pre-existing condition exclusion if you have had continuous insurance and are going from a group plan to a group plan.

Unfortunately, if you are buying individual coverage in a state that allows for medical underwriting, you can indeed be denied completely, or have certain conditions excluded for a time or even permanently. This all depends on where you live. The band, or any WLS, can absolutely have an impact on your future insurability, but to what extent will vary depending on where you live.

To get the details for your state, go to your state's website and search for "individual health coverage" for the terms and regulations in force.

Share this post


Link to post
Share on other sites

Cathy, I am an insurance agent in the state of Oregon. In this state you would probably get turned down for private insurance (if banded with in 5 years). A group insurance would have to take you. If group wasn't an option than you could apply to the Oregon Insurance Medical Pool. The law states you should be able to get insurance at an affordable price. Ha! Its more expensive than individual policies. I am unsure about other states laws. Good luck!

Share this post


Link to post
Share on other sites

I was under my fathers insurance for the surgery and it went under his (they gave me the approval) now im under my mom's as a full time student and have been since january. (i Live in illinois) so would my mom's cover the fills... im still waiting for bills from the past three fills i've done.

Share this post


Link to post
Share on other sites

Thanks for the input everyone. I now have one answer, from Blue Cross of CA (my current group insurer). No coverage for two years after banding, then coverage if you pass a physical and blood tests, and your weight has stabilized. Premium surcharge is 25%. Checking others, but suspect it's similar. I'll end up on COBRA until the two year mark then see if I can get a lower premium than that.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • 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
      · 2 replies
      1. Bypass2Freedom

        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.


        This is a place to feel safe to vent, seek advice, hopefully without judgement.


        Compassion goes a long way :)

      2. BabySpoons

        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...

    • Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

      2. Theweightisover2024🙌💪

        That sounds awesome. I'll have to check that out thanks!

    • BeanitoDiego

      I've hit a stall 9 months out. I'm not worried, though. My fitness levels continue to improve and I have nearly accomplished my pre-surgery goal of learning to scuba dive! One dive left to complete to get my PADI card 🐠
      I was able to go for a 10K/6mile hike in the mountains two days ago just for the fun of it. In the before days, I might have attempted this, but it would have taken me 7 or 8 hours to complete and I would have been exhausted and in pain for the next two days. Taking my time with breaks for snacks and water, I was finished with my wee jaunt in only 4 hours 😎 and really got to enjoy photographing some insects, fungi, and turtles.
      Just for fun last week, I ran two 5Ks in two days, something I would have never done in the past! Next goal is a 10K before the end of this month.
      · 0 replies
      1. This update has no replies.
    • Teriesa

      Hi everyone, I wrote back in May about having no strength. I still get totally exhausted just walking from room to room, it’s so bad I’m using a walker with wheels of all things. I had the gastric sleeve Jan. 24th. I’m doing exactly what the programs says, except protein shakes. I have different meats and protein bars daily, including vitamins daily. I do drink my fluids as well.  I go in for IV hydration 4 days a week and feel ok just til evening.  So far as of Jan 1st I’ve dropped 76 lbs. I just want to enjoy the weight lose. Any suggestions or has anyone else gone thru this??  Doctor says just increase calorie intake, still the same. 
      · 0 replies
      1. This update has no replies.
    • Stone Art By SKL

      Decorative Wall Cladding & Panels | Stone Art By SKL
      Elevate your space with Stone Art By SKL's decorative wall claddings & panels. Explore premium designs for timeless elegance.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×