Who EXCLUDES this surgery?

[Guest BikiniBeachy]

I know I've posted a million times about Kaiser...but the person I'm technically a 'dependent' under wants to shop around more....

I know Aetna excludes Bariatric Surgery on their Individual plans, does BCBS, United, Cigna or Humana?

[raedelicious 0]

The school district I work for carries BCBS of Texas...the school district has an exclusion policy and they say that the reason is that the insurance company recommends that they exclude all bariatric services...what a crock of #$%^!!!

[amanda2008 0]

It depends on the plan. I don't think all companies exclude it totally from all their plans.

I have United Health Care and on my policy it is excluded. I work for a small company (fewer than 15 people have the policy) and I'm sure they chose the cheapest plan possible. Not all people who have UHC have exclusions as you can see from this board.

Exclusions should be ILLEGAL.

[CrueFan 0]

Well our company is nationwide and a co worker of mine just found out today that Anthem BCBS no longer covers it. I had originally called to inquire about PS. Then the lady said we dont cover that ( the bariatric surgery ) so they wouldnt cover the PS. I told her well I had it a year ago , apparently they changed their rules in January. They no longer cover it. I feel so bad for her, its the only thing she has had to look forward too. So I guess it doesnt matter what the company size.

I was lucky I got in before it changed, but for those who are having issues. Many insurance companies have been sucessfully sued for weight discrimination. You might want to research just to have your own ammo. I do know zerox was one that got nailed for it.

[Brandy~ 2]

I know I've posted a million times about Kaiser...but the person I'm technically a 'dependent' under wants to shop around more....

I know Aetna excludes Bariatric Surgery on their Individual plans, does BCBS, United, Cigna or Humana?

BCBS of Minnesota pays for it. I live in Oregon but have this plan from my employer.

[Mom2_4 0]

The financial coordinator at my clinic said that United was the easiest company to get patients approved through. I do know someone who has United and their policy has an exclusion though.

[kamicola 1]

I am a teacher in WA State and two weight loss surgery centers told me that teacher's insurance (all of the options) either exlude it or you have a nearly impossible time getting it approved through denial and appeal process. So... since my husband and I are teachers and need to get the surgery done and my parents are also getting it done (and their insurance - Pacific Care) doesn't cover it either.... we decided to check our Mexico... the surgery up here is on average $18,000 and it is only $7,500 down there... so we found an excellent and highly recommended surgeon in Tijuana and are so happy to all be getting banded at the end of May.... just a thought for any of you who can't affort it up here and need to get it done and your insurance doesn't cover it.

Kammi in Everett, WA

soon to be banded 5/27/08

Dr. Kuri - Mexico

[wendy645 1]

Well, don't go for Mercy Care Az.

*sigh*

Best of luck!!!

[Joy1234 0]

So did you pay out of pocket? I'm curious, as my husband's company does not include WLS on their insurance plan...I now know it's called an exclusioin...I've posted already tonight, but thought I would again to you...have you heard of anyone trying to "fight" the company on their exclusion? If so, how did they do it, and or how did you do it. I'm new to this and I dont' have a clue as to how to post! :biggrin: