Which Insurance Companies Cover the Lapband?

Michael · August 5, 2007

I'm in the process of getting insurance on my own because the company I work for has crappy insurance. I've spent some time looking on ehealthinsurance.com and so many of the policies under limitations and exclusions, state they don't cover weight loss surgery. I've looked at Aetna PPO and others, and they state they don't cover.

What I really need is someone to tell me specifically which insurance company and policy name they have that is covering the surgery. Even if it's has requirements like 6 months of medically supervised weight loss or other requirements, I understand having hoops to jump thru. I'm in Texas.

Thanks.:help:

Alexandra · August 5, 2007

Michael, in some states you are not even eligible for individual health insurance if you are eligible for a group plan. Please make sure that's not the case in Texas before you go too far down this road.

Michael · August 6, 2007

Thanks. I actually do have the choice of getting health insurance on my own. Half of my fellow employees have it on their own. It has to do with the size of a company and the profession. The company I work for is small, under 25 persons.

Candle · August 7, 2007

I have a self pay policy in NY that covers it but they are only in NY. What state are you in?

mermaidpuppy · August 7, 2007

My BCBS NC approved my surgery the day after I faxed the last piece of "Pre-op" testing to them. It's BCBS PPO. I was preparing for a battle, but no need. Also, I didn't have to do the 6 month supervised diet plan. I just had to have the last 5 years of records weights by doctors. I only had 3 yrs of history since I didn't go to the dr regularly, so they accepted 4 out of 5 and the accepted a dated picture for one missing year. Really easily. I'm set for surgery on Aug 23rd. Good Luck to you!

Alexandra · August 7, 2007

Thanks. I actually do have the choice of getting health insurance on my own. Half of my fellow employees have it on their own. It has to do with the size of a company and the profession. The company I work for is small, under 25 persons.

OK, so now the question is...what state are you in? Rules and regulations vary considerably from state to state. Some states allow carriers to exclude areas of treatment and others don't. Also, do you have insurance now?

Michael · August 7, 2007

I'm in Texas. I have noticed that there are different policies for different states, which seems weird. Insurance companies are just so complicated. On my job, I do work for insurance companies and workers compensation, and I never understand why they do things the way that they do.

I've read info from other sources that have said WLS is excluded by the insurance company unless it's medically necessary. So, I guess that means that it can get approved but you have to prove you need it.