Individual Insurance in Southeast TEXAS

January 27, 2005

Hello,

I've recently began looking into having the lap band procedure. I currently have aetna insurance. They basically said no to the procedure approximately 1 year ago. I'm somewhat afraid of going to Mexico to have the procedure. In as much, I'm wondering if anyone has had the procedure and successfully used an insurance company that was not associated with his/her employment. If yes, please help me. I'm desprate. My body hurts and I'm having some health issues associated with being obese. I'm even considering trying to pay for the procedure out of pocket. Thank you in advance to anyone who can assist or even takes the time to read this thread.

Alexandra · January 27, 2005

Hi Ms. Mitchell:

Before you look into individual insurance, I'd suggest you try again with Aetna. Their stance has changed somewhat on the band and if you qualify medically you have a much better chance with them than you would have had a year ago.

Are you covered under one of Aetna's standard insurance plans? What were their reasons for saying no a year ago?

January 31, 2005

Hi,

It seems that Aetna wants me to die... LOL. I apparently don't have eough ailments to qualify. I've been looking into private insurance companies. They seem to pay readily but only offer policies that cover morbid obesity to employers for their employees. Individuals seeking coverag are being assigned to sister companies that don't cover morbid obesity.

I spoke to an AETNA PPO representative a few days ago and I was informed that no coverage would be available for fills/maintenance/emergency removal of the device if I was not approved for coverage to implant the lap band. That really scared me, because I was considering paying for the entire process out of pocket. Locally, this can cost as much as 18,000.00 for the implant, 200.00 for any followup visits, and finally, 100.00 minium for a fill. That's quite an investment for me especially being well aware of my having to pay for the removal of this device if an emergency should occur.

I see you sell/broker insurance. Do you have any advice?