Obtaining New Health Insurance After Lap Band

[cathgr8 1]

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?

[Mary-2b150 0]

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..

[Alexandra 55]

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.

[ms925 0]

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!

[Jeni 85 0]

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.

[cathgr8 1]

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.