shopping ins.. which should I choose for lapband???

[CoolBrze198 0]

I started the process year before last. But UHC denied me. And then denied my appeal. So I gave up... :smile2:

I am thinking very seriously about findind new insurance. So, I am asking for any help on who to chose and what plan. (I am health insurance illiterate)

I would like to find someone to cover this and the premiums not be thru the roof.

Any suggestions you can give will be greatly appreciated !!!

TIA,

Rosanna

[coltonwade 27]

I started the process year before last. But UHC denied me. And then denied my appeal. So I gave up... :eek:

I am thinking very seriously about findind new insurance. So, I am asking for any help on who to chose and what plan. (I am health insurance illiterate) :thumbup:

I would like to find someone to cover this and the premiums not be thru the roof.

Any suggestions you can give will be greatly appreciated !!!

TIA,

Rosanna

If you have health care now I would stick with it. Most private label insurances do NOT cover the band. If the UHC Plan you have does not EXCLUDE the band keep trying with them .

they expect you to give up . If its not an exclusion in the policy then something in the paper work is probably not right . What was the reason for the denial ?

If you have seen ANYONE for the band it will be preexisting most likely and private insurances will either exclude it or make you wait a yr.

I own my own business and NOW can not get ANY Insurance due to being banded. I have to go through the Texas high Risk health pool and pay $400 a month for JUST ME !

So if you have a group plan you might be better off sticking with it.

I could not find anyone that covered the band private insurance wise !!

HTH

Mindy

[MacMadame 81]

I tried to get private insurance 3 years ago when I got laid off and I was denied for being overweight. So was my husband even though his BMI is below 40 so he's only obese, not morbidly obese.

It's going to be very hard to find private insurance that will take you, let alone pay for WLS.

[coltonwade 27]

Yes Before I had WLS I was denied for Migraines AND being Obese.

I am pretty sure it had more to do with being Obese than my migraines.

If you have insurance your just better off staying with it , because if you go off it for some reason you may NOT get it back .

Group insurance is different they pretty much have to take you .

Private health insurance is a WHOLE different world , they can and will turn you down for ANYTHING !!

mindy

[CoolBrze198 0]

:smile2:

Thanks for your replies.. I guess I will stick with what I have.

I was denied for WLS due to not having 5 years of BMI of 40+

I had just over 3 years.

Then it seems like not long ago (within a year) I got like an update to our coverage book that WLS was excluded.

I have UHC Choice with my husbands work.

My work also has UHC, but not sure of the plan. I even thought maybe switching to our insurance. I will get a benefits book from a co worker and see if there is an exclusion. If no exclusion and I should swithc ( just a thought here) How long should I wait before atempting to even try to get approved?

Or should I just face the facts that I will not be able to have surgery unless I save the $$.

[coltonwade 27]

:tongue2:

Thanks for your replies.. I guess I will stick with what I have.

I was denied for WLS due to not having 5 years of BMI of 40+

I had just over 3 years.

Then it seems like not long ago (within a year) I got like an update to our coverage book that WLS was excluded.

I have UHC Choice with my husbands work.

My work also has UHC, but not sure of the plan. I even thought maybe switching to our insurance. I will get a benefits book from a co worker and see if there is an exclusion. If no exclusion and I should swithc ( just a thought here) How long should I wait before atempting to even try to get approved?

Or should I just face the facts that I will not be able to have surgery unless I save the $$.

Sorry for the insurance issues. I woudl check into your plan see if they cover it ? As far as waiting ? Im not sure about that . I know someone who switched insurance plans and 4 days later had approval ?

I dont think there is a set time ? But someone else might give ya a better answer ? Personally I think i would pay a premium or 2 first LOL

Mindy

[MacMadame 81]

I have UHC Choice with my husbands work.

My work also has UHC, but not sure of the plan. I even thought maybe switching to our insurance.

If you can switch from one group plan to another, that is awesome. Group plans can't deny you (with certain limited exceptions). I thought you were talking about buying private insurance. That's a whole 'nother ball of wax!

UHC does not require 5 years of morbid obesity according to their Bariatric Surgery Medical Bulletin. Have you considered an appeal?

[coltonwade 27]

If you can switch from one group plan to another, that is awesome. Group plans can't deny you (with certain limited exceptions). I thought you were talking about buying private insurance. That's a whole 'nother ball of wax!

UHC does not require 5 years of morbid obesity according to their Bariatric Surgery Medical Bulletin. Have you considered an appeal?

her plan added an exclusion . If they have excluded it there is nothing she can do .

I agree if you can shop different plans then that would be good, see which plan covers WLS . Also BEFORE you pick if you find a plan that covers WLS speak to some of the WLS docs in your area and see if they have had success getting it covered .

HTH

Mindy

[CoolBrze198 0]

Thanks again for the new replies...I will be looking at a coworkers benefits books tomorrow if she remeber to bring it to work.

I have been searching for the letter I got a while back that I think put WLS as an exclusion. But for the life of me cant find it.

If for some miracle that the WLS wasn't excluded and I was denied last year, then my appeal was denied as well. Do you think I should resubmit everything again has it been to long for me to appeal again???

My 5 years should be up early next year. *fingers crossed* that the exclusion was a figment of my imagination.. lol

Will keep you up to date on what I find out.

And thx for all your replies,

[MacMadame 81]

If for some miracle that the WLS wasn't excluded and I was denied last year, then my appeal was denied as well. Do you think I should resubmit everything again has it been to long for me to appeal again???

It really depends on your insurance. Maybe you should talk to Obesity Law. (ObesityLaw.com) about it. They'd know what kind of questions you need to ask your insurance company and how to interpret the language of the appeal.

[coltonwade 27]

That is a great Idea I forget about Obesitylaw.com

Mindy