Switching Insurance Companies midstream...

BeTheBuddha · July 14, 2008

Hi:

I am curious to know if anyone has had to switch insurance companies during their lapband process (i.e. one company for the surgery, another company for the fills).

Here's my problem: I got approved for surgery right before I got a great job offer. I had the surgery before I left my old job (BCBS insurance) and my new job has a 90 day probation period before I can start my new insurance (Aetna). During the interim, I will do COBRA, of course.

But will I have to get re-approved by Aetna once I start that insurance so that I can get fills in the future?

How do I go about doing this? And have you ever had to do this yourself?

ocbreeze4u · July 15, 2008

I have Aetna PPO and as long as you do not have a lapse in insurance of more than 30 days then they will cover pre-existing in most cases.

kgloverii · July 15, 2008

Yes, you will have to be reapproved. If there is a way for you to start your fills are on COBRA, that will relieve a lot of headaches. You will have to meet all of Aetna's qualifications... also, if there is a weight loss surgery exclusion on the Aetna policy, it will not be covered.

Mikochan · July 16, 2008

I know you probably got your answer, but to anyone who doesn't have Aetna, beware of switching insurance!

I was on COBRA to get my lap band surgery because my previous employer's plan paid 100% and my new insurance plan only pays 80%. I just called my new insurance company and I got so mad at them because they said that they don't think that ANY follow-up, including fills, will be covered. She said that she doesn't think that I can get approval now because the surgery was already done. I sure hope that the woman doesn't know what she is talking about! I am definitely appealing it if that's the case. It seems so dumb that they won't pay for fills. She said that no insurance company is going to pay for follow-up for a procedure that was done with a previous insurance company. If that is the case, then does that mean that a cardiac patient won't be covered for a cardiologist visit if he got heart surgery 5 years ago under a different insurance???? :blush:

Edited July 16, 2008 by Mikochan

ocbreeze4u · July 17, 2008

I talked with my Aetna Insurance today and they do cover fills from previous ins. as long as there is not a lapse in insurance over 30 days when ins. changed but that is just MY policy. My employer did not exclude WLS in their Aetna Ins. Policy for all of thier employees nationwide. Obvioulsy it depends on what the exclusions are and every group policy is different. Sorry I was wrong previously in my recent post.