A Kaiser question I'm afraid to ask...

Okay...So I have a new job...and my benefits are on track to start in June.  And I'm really ready to start working with a PCP towards my goal of WLS....but does Kaiser have an exclusion for obesity as a 'pre-existing condition'?  Will this mean I'll have to wait until next year to be considered for surgery?  I've been so excited about finally having medical coverage (I've been on MediCal for the past 2 years)...but this thought just popped into my head 'cause I know that some insurance companys have this kind of 'waiting period'.  Does anyone know for sure?  I'll appreciate any knowledge anyone has about this.  I just want to be real before I start getting my hopes up.  Thanx alot

Hi sweetie! As far as I know, Kaiser does NOT have that exclusion. They do however make you take the 24 weeks preop class, but I firmly believe it is necessary and helpful and it really goes fast!  I'm so excited for you to finally have medical insurance through a job, I hear you on that one!!! That is how I got my WLS, finally having a job that had Kaiser. Now I'm on the Medi-Cal and I hate it! Lord only knows how long SS will take to decide if I'm disabled either for the better insurance. I can't afford the share of cost with what I have now!!!  I'd say go ahead and get the ball rolling. I know here in SD you have to have a health appraisal appointment to get started. My fingers are crossed for you honey!!! Have a great weekend! big hugs and love, Becky PS. I will get cruise pics up this weekend! Do you have MySpace too???

Hi Becky!  Thank you so much for responding.  I can DEFINTELY relate to your Medi-Cal/SS situation.  Be assured,God will guide you through these murky waters of waiting and red tape.  He's been with you through all of the troubles, changes and challenges you've been dealing with -- he's not about to abandon you now.  My heart is with you, sweetie, always.  I'm trying to have faith and take in the reality checks I've been getting on this Kaiser issue.  I tossed and turned all last night after the thought sleazed its way into my mind.  Now that my hopeful flames of ever having WLS are slowly coming back to life, I have to try and stop myself from dousing them out with doubts and biting self-criticism.  It feels so good to be back in the OH community.  It's the only place I feel truly understood.   I'm totally psyched to see your pix!  I do have MySpace, too -- I'll pm you my email addy today.  Thanks again for the info, Becky.  You're amazing. {{{{{Hugs}}}} 

Hi as someone that recently went through the Kaiser program in SF they do not have any exclusions especially weight related ones....it is up to your PCP if they refer you to the program. Also Kaiser does offer a WLS seminar that you can attend to learn about the program. My PCP Dr. Calloa is great and knowledgeable if you are looking for a PCP...good luck to ya!!

Thanks so much for the info, T.  I can't say enough about how awesome it is to have a forum where I can ask questions like this and not be treated like a dope for asking.  I'll definitely be checking out Dr. Calloa.

Hi, I actually work for KP and to answer your question it depends on your coverage. If you are covered through a large employer group, you typically will not have this exclusion. However, if you are covered through a small employer group, they do have the option of excluding specific services. It sounds like you are ok, but if you really want to know, contact Member Services at 800-464-4000. You can also email me directly and I will have one of my friends in Benefits check your specific plan to let you know for sure.  Additionally, the only time we exclude pre-existing conditions is on our Personal Advantage (individual coverage) plan where we do a medical screening before granting coverage. I just had surgery last week.... so please keep in touch and let me know how thing go and don't hesitate to ask me anything related to KP. I have been there forever, there is not a question that I probably can't answer or can't get the answer to.  Tae

Hi Tae, Thank you sooo much for this info!  I work in a small dentist office (it's just the dentist, our bookkeeper and myself).  All I know is she has the Kaiser plan for small businesses.  I could get you our account number when I go back to work on Monday.  It would wonderful if one of your friends could check the details in our plan -- I'd appreciate that so much.  CONGRATZ on your surgery!  I hope it went well.  I wish you a smoooooth and relaxing recovery.  I'll pm you on Monday with our account number.  I hope you're having a nice weekend.  Thanks again for your reply.

Hey there you are fine because when you have benefits through an employer your physical condition is not a concern for elibility because your medical coverage is considered group coverage it is when you try to apply for Kaiser as an individual and pay out of pocket each month that they can deny your application based on too high of risk. Girl get it working with your PCP ASASP and get the referral you need to the bariatric preventive medicine dept. I am a kaiser gal and I just had my WLS 11 days ago feel free to PM me  Take Care, Jessica

Hey Jessica, Thanks so much for your reply.  I can't wait to get things going with a Kaiser PCP.  June can't come fast enough for me!  CONGRATZ on your surgery, too!  How did it go??  I'm wishing you warm, healing vibes  for a smooooth recovery as well -- it's so cool to hear from so many new post-ops!  I hope to join you gals on the losers bench one day.

Hi, I see you are from San Francisco.  I went to Kaiser South San Francisco for mine.  All I had to do was be referred by my PCP.  The Lifestyles classes I took were not 24 weeks.  I had to go to 4; however, two of them are now combined.  You'll have to see the dietician and mental health clinician, as well as meet your surgeon.  My entire process took 31/2 months from start to finish.  South San Francisco Kaiser is a leader of Bariatrics in the nation and I would recommend them over and over.  My surgeon was David Le; he's wonderful.  If you are a smoker, or have a C-PAP machine, on birth control pills, they'll make you get off of them, so that may take a little longer.  But most of the time there is time to discontinue these things as you attend your Lifestyle classes.  Kaiser was awesome.