Self Pay & No insurance? - Interesting tidbit

[JaxBandster 11]

I was at my insurance agent's office today on another matter and

mentioned to her that I was having Lap-band surgery in a few weeks. I

am currently unemployed and have no insurance to cover my surgery so I

am making other financial arrangements to cover it out of pocket.

She proceeded to inform me about a type of major medical policy for

people who do not have insurance that will reimburse a portion of your

surgery/physician/anesthesia expense (plus other expenses if need be).

The premiums vary, but the plan I am looking at is $61 a month. Once

you have the surgery you can cancel the policy, so you are essentially

just having coverage for a month. The amount reimbursed varies

depending on the insurance but I am looking at getting back as much as

$2,000 to cover some of my expenses. It's not a ton but is more than

10% of the cost of my surgery which is nothing to sneeze at.

Just thought this was really interesting and something that people may

want to look into if they are having to dig into personal savings or

using credit to cover their surgery. (P.S. They will also write

policies on plastic surgery as well).

[Sula 0]

So, what is the name of the insurance and how do people get it?

[JaxBandster 11]

So, what is the name of the insurance and how do people get it?

My insurance company is Allstate. All you have to do is fill out forms and pay the premium. I would imagine that other insurance carriers might have similar types of coverage though. I will try to find out the exact type of coverage (and plan name) tomorrow when I speak with her again. She actually had two types of plans to offer and was going to see which one would reimburse more and get back to me.

[MissMom24 2]

My sister is looking into the band as well, any information on this would be great. Phone number, email, anything!

Thanks:smile:

[JaxBandster 11]

My sister is looking into the band as well, any information on this would be great. Phone number, email, anything!

Thanks:smile:

Once I find out the exact name of the policy I would just find a local Allstate agent and see if they offer it. I was really astonished when she told me about it. I had gone to her in order to obtain a copy of an EKG they performed on me a few months ago when I was taking out a life insurance policy on my husband and myself. My doctor said he could use the EKG the insurance company did in lieu of my having to pay for another one. I'm really glad I had to contact her or I would have never known about it.

[elyssa 0]

Great info. Thanks. Also can anyone tell me what PB stands for?

[JaxBandster 11]

Great info. Thanks. Also can anyone tell me what PB stands for?

PB = Productive Burp

It is a burb that includes food, usually something you just ate, that is caused by eating too much or a variety of other reasons.

I believe there is a list of acronyms somewhere on the forum.

[coltonwade 27]

I beive its called a Mini Med policy i looked into it too but not all policies cover it. Also most of the time you have to pay for it first.

Also just FYI since you said your not employed and do not have insurnace as of right now . If you do not plan on getting on a group plan after your surgery or if you need insurance soon , get it before surgery .

After surgery its nearly IMPOSSIBLE to get insurance , I have not found a plan that will cover me . Im deemed " Permanatly Un insurable" now that i have my lap band with private health insurance with my insurance agent ( Stat Farm ) and the insurance they carry .

I have to be on the Texas High Risk Health Pool Insurance .

Group plans have to cover you because they do not have pre existing conditions clause.

SO anyway just wanted to give you a heads up .

Mindy

[elyssa 0]

ok. One more stupid question. How do you get the weight loss ticker to show up on your posts? I made one at the website but dont know how to get it here.

[faithmd 14]

http://www.lapbandtalk.com/f112/ticker-instructions-help-47581/

http://www.lapbandtalk.com/f112/how-create-ticker-add-your-signature-47643/

[JaxBandster 11]

Thanks for that information. I will check into it. Hopefully, I will get employed soon after my surgery so I can get coverage again. I don't mind paying out of pocket first as I was planning on doing that anyway, but knowing I can recover a portion of the costs is nice.

I beive its called a Mini Med policy i looked into it too but not all policies cover it. Also most of the time you have to pay for it first.

Also just FYI since you said your not employed and do not have insurnace as of right now . If you do not plan on getting on a group plan after your surgery or if you need insurance soon , get it before surgery .

After surgery its nearly IMPOSSIBLE to get insurance , I have not found a plan that will cover me . Im deemed " Permanatly Un insurable" now that i have my lap band with private health insurance with my insurance agent ( Stat Farm ) and the insurance they carry .

I have to be on the Texas High Risk Health Pool Insurance .

Group plans have to cover you because they do not have pre existing conditions clause.

SO anyway just wanted to give you a heads up .

Mindy

[JaxBandster 11]

I spoke with my insurance agent again today. She informed me that it is a supplemental health insurance policy and that it is done through American Heritage Life which Allstate owns.

She said that I could give out her name and number and that anyone from any state could call her and that if she wasn't licensed in a state she could definitely refer to another agent. I will at the very LEAST get $500 plus $130 per appt. The ambulatory surgery rider varies depending on the doctor's report but could be as much as $1,800. I figure that is worth a $61 premium.

My agent's name and number is

Karalee Sievert

904-819-0595

[make33 2]

Elyssa: I had such difficulty at first, I made up these instructions for anyone who needs it:

For the Ticker Factory: go in and create your own ticker (be sure to remember your password!)

At the end, highlight everything in the top box (the bb: box), right click and hit Copy.

Then come into this site and go to UserCP in the Menu Bar. Go to Edit Signature on the left. Left click in the big box. Then right click and hit Paste. You should see your ticker appear.

Be sure to go to the bottom of the page and click on Save Signature.

When it comes back, you'll see your ticker at the top of the page. (Then to change it, all you have to do is to double click on the one at the top of the page)...<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>

__________________

<o:p></o:p>

<o:p> Good luck to you!:tt1:</o:p>

[010308 0]

Group plans have to cover you because they do not have pre existing conditions clause.

Mindy

Group plans cover you because it is insurance offered by an employer, it has nothing to do with a pre-existing condition clause. A pre-existing condition clause states that when you become insured you will have a specific period of time after coming on coverage with your new insurance plan where you will not receive coverage for any condition you have been treated for prior to coming on coverage. The look-back period (meaning how many months from your effective date your insurance carrier will review records to determine if you had received treatment prior to coming on coverage with them) and the review period are set periods of time. For example, in the state where I live it is common for medical insurance carriers to have a 9 month waiting period for a pre-existing conditions with a 6 month look-back. That means that for the first 9 months that you have coverage if you receive medical services your insurer will request records from your doctors office for the 6 months before your effective date so they can see if you have ever been treated for that same condition before. If they find that you were treated then they can, and most likely will, deny any claims related to that condition. There are situations in which the pre-existing condition clause is waived and I won't even get into that or I might be here all night.

The reason that I am mentioning this is because the person who is getting WLS immediately prior to getting group coverage will be subject to the waiting period of her new plan (if it has one), and that means that if the new plan has coverage for obesity treatment she may have problems receiving coverage for that during the first several months she is covered.

I should also note that I am only familiar with the laws in the state where I reside, and these probably vary state to state.

The purpose of waiting periods is to protect the insurance carrier (thereby protecting it's existing members) from people choosing to get and pay for coverage for a short period of time after they find out they need medical treatment.

[tottie1990 0]

Why would a person be deemed uninsurable after the lapband? It seems you would be a better risk after losing some weight than before.