Insurance Coverage Denied After Lap Band Surgery

[kellyk 0]

I am hoping someone here may be able to give me some guidance or answers.

I had the lapband surgery in Mexico by Dr. Ortiz in May 2005. In October 2006, I moved from Michigan to Florida and became self-employed as of January 1, 2007. I applied for private health insurance (not employer-provided) in December 2006 with Aetna. I was declined coverage due to the lapband. I have also contacted Humana One here and have been advised that they automatically decline coverage for any applicant who has had the lapband procedure. This has absolutely nothing to do with the fact that I had the surgery in Mexico. It is the procedure itself that is causing me to be declined coverage.

I have no health issues whatsoever and have lost over 70 pounds since the lapband. I am now at a healthy weight and have maintained it for 2 years.

I am now sitting with no health coverage whatsoever and am being told that I will not ever be able to have it unless I become employed by a company that provides coverage as a benefit.

Has anyone here run into this problem? I have to tell you, if I had known that having the lapband would cause me to be denied insurance coverage afterwards I would have NEVER had the procedure.

[ajoneen 0]

try going to this site

www. obesitylaw.com

might be able to help. Good luck.:huh2:

[phazer08 15]

EXACTLY the same problem here. I am on my husband's COBRA that expires Jan 1 (he retired and is on Medicare, I'm 53 so have quite a while to go). Called a health insurance specialist to find a new coverage (I.e., non-group). Frankly didn't mention Lap Band because there are days I forget I have one. I certainly wasn't trying to hide it as I didn't know it would be a problem!. Got all the way thru the interview with Humana, mentioned lapband and she immediately denied me! My agent said "oh, if I'd known that, I wouldn't have sent you to them!" so she called the "easiest" company to get approved from and they said it was an automatic-deny! It's considered a pre-existing condition.

What she told me my options were was a simple plan that covers office visits as well as Tier 1 & 2 meds. Major medical on a negotiated fee depending on the procedure (for example $5,000 for appendicitis). Combine that with a gap coverage plan like AFLAC for any catastrophic things like a major accident, cancer or stroke. I'm still looking into that.

The other option is get into the State of Texas high-risk pool. I haven't had a chance to look into this yet. I'm so peeved that I did this to become healthier and now I'm considered high-risk!

Last option is to contact the group coverage I'm in now, tell them I have been denied, and they MAY extend their coverage, but it will be pricey.

Of course...there's the option to get my current employer, with whom I am part-time, to let me in to their plan and I'll pay my own way. Not sure I want to go there with them.

One thing my agent did tell me was if I hadn't mentioned it and IF no American doctor had it in their files,then I might have slipped through. Too late now plus didn't really want the risk of being found out...not to mention the dishonesty aspect.

So, yeah, color me shocked and peeved. The agent said if Obama's health plan passes thru then in 2014, pre-existing conditions can't be a cause for denial. I'm not holding my breath.

Anyone else out there?

[Grider 92]

_{Did they not say NO MORE PRE-EXISTING conditions??? Dang I thought the new law was in place!}

[new chapter in life 5]

yeah ur right about the no more pre-existing conditions---but I noticed the 1st post was in 2008, so maybe she has had better luck w/the change in the laws

[phazer08 15]

That part of the new law, if it stays, doesn't kick in until 2014

[Humming Bird 275]

Several years ago I was denied because of my weight. I weighed 240 at the time (not my highest).

I wonder if the same company would deny me now that I have a normal weight, but have lapband.

It might be worth it for me to apply with them again.

[phazer08 15]

As my mom would say, "Damned if you do and damned if you don't."