Mountaingal 322 Posted August 1, 2009 Has anyone heard anything mentioned anywhere in the new health care proposals about WLS? I am wondering if I self pay for the banding if there is any possibility in sight that help might be available to pay for aftercare (fills) including any complications. Thanks for your input! Share this post Link to post Share on other sites
ThinAli 0 Posted August 1, 2009 For various reasons letss just hope that these proposals don't go through!! I don't think WLS has been mentioned but I don't know if it will be anything of great quality. You are better off finding a doctor now and your own insurance that will give you really good coverage. I have a PPO so I pay a decent part of things, which it sounds like you don't mind paying if you want to self pay, or can. But HMO's pay for everything including fills and all after care. I am not trying to be offensive but things don't come for free and one should take care of yourself first. We should not depend on the government for everything! And before people jump all over me in CA medi-cal pays for lap band and all the after care! So even those without insurance can get the surgery. Which is great that they have options! Share this post Link to post Share on other sites
ParrotheadCathy 0 Posted August 1, 2009 ThinAli, Let me point out that you made a sweeping statement that is incorrect. All HMOS do not pay for lap band surgery. I know, because MY HMO contains a written exclusion for any and all weight loss surgeries. I've said it many times here. EVERY POLICY is different. Your employer negotiates the coverage for which is it willing to pay. Just because Jane Doe's BCBS HMO paid for her LBS does not mean that John Smith has the same coverage under a BCBS HMO from a different employer. MountainGal, even if the President's health plan is approved, it won't be in this session (they are now off for August). And it will take some period of time to ramp up and get it operational. Certainly not overnight. In the meantime, how long would it be before you know what kind of coverage it might end up providing? Or even if it will apply to you. I mean, I even see the possibility of it being gutted down to guaranteeing coverage only for those who have no insurance, like say all the unemployed or workers whose employers don't provide any insurance (like fast food and retail, etc. because they make sure to not give them employees enough hours to qualify for such things). One of the things that is a tiny part of the health plan is to eliminate exclusions for pre-existing conditions. That would keep thousands, if not millions, of Americans from being underinsured ... that is, no coverage for a condition covered under a previous policy but excluded from a new plan because it existed prior to enrollment. The plan has good and bad but somewhere in the middle a hell of a lot of people would benefit.... We'll have to wait and see. Share this post Link to post Share on other sites
ThinAli 0 Posted August 1, 2009 Parrothead, Sorry to have hit a nerve with you and set you off on a rant. I never claimed to be an expert! Evidently you are and have more experience! I know of people who generally consider their HMO crappy yet they have paid for everything so you hopefully can understand where my impression came from. So I bow to your superior knowledge on the subject. Just giving my perspective from my limited knowledge and from what I have been told. Share this post Link to post Share on other sites
ParrotheadCathy 0 Posted August 1, 2009 Relax, that's no rant. Just stating facts. I have a BCBS HMO and, as I said, mine specifically says it will not cover any weight loss surgery. My best friend, who had surgery exactly 2 weeks after me has a BCBS HMO as well and hers says it will cover weight loss surgeries BUT you have to have had a BMI of 37 or higher for three years; hers was that high for only 18 months so they denied her. That's employer negotiations that are based on cost control .... what can be provided for a specific cost. I would hate for someone to see you say HMOs pay for it and everything else....only the have their hopes dashed when they are denied. This isn't the place for a debate of the healthcare plan, but something has to change because a huge number of people have no insurance whatsoever, are not eligible for assistance as far as medical care, and just pray daily that nothing disastrous happens to them. Share this post Link to post Share on other sites
Tory09 1 Posted August 2, 2009 Things will certainly get MUCH WORSE with government run healthcare. You think healthcare is bad now, it will be horrible if gets approved. My opinion is to get the surgery now before things get worse! Just my 2 cents ... Share this post Link to post Share on other sites