is it true that connecticut insuranc companies wont cover gastric bypass??

my workplace has an exclusion to our policy that says it wont cover any weight loss surgery, but the people in HR didnt know that. so she called the insurance broker and was told that there are NO insurance companies in the state of Connecticut that will cover that surgery. is this true? I have connecticare, inc...please help me if you have any other info.

I highly doubt that is true unless this is something new... because there are many of us that have had it covered. My company purchased the rider to have GBS covered. What doctor are you thinking of going with? Good luck, Chrissy

I have Aetna, not sure if my company got the rider or not, but I know it is covered. I know I work for a very large company, ok it's Bank of America, so they might have bought it. Good luck. Kathy

Kathy, More then likely they did buy the rider. Large companies tend to buy the rider... I am at well know insurance company and they bought the rider too. If you work for a small company, chances are they might not buy the rider.... it doesn't hurt to ask though. What you should do is get the GB code from the dr. you plan on going to... call the insurance company with the code and see if it is covered and if it is what if any restrictions or programs need to be met in the mean time. Good luck! Chrissy

p.s. the HR Department shouldn't have talked to the broker... they should have talked to the ins. company. the brokers tend to know squat.

i actually talked to the insurance company and they said that it is an exclusion to the policy we have. i cant exactly change jobs..i have been there for 18 years, and have no desire to go elsewhere. i guess that i have no other choices...

Hi Jennifer, Ask if you can purchase the rider and ask your surgeon how much self pay is. See what is least expensive and see if you can afford it. There are medical loans also available out there and some surgeons also offer a payment schedule... Just like a car payment type of thing. I think they mis-spoke as to "no insurance companies pay for this procedure in CT"...there would NOT be one surgeon left in this state doing GBS if it was so. This is why Dr Aranow is fighting the CT state legislature in trying to get a law passed saying that insurance companies have to cover this insurance...that the end result is cost effective for them in the long run because they don't have the long term health costs of the co-morbidities due to obesity. If there's a will, there's a way. If you want this bad enough, it'll get done...and be paid for in some way shape or form. If you've been with this employer for 18 years, ask them to pay for the rider or at least share in its cost...you'll be better off to them as a thinner, healthier person than an obese one. More productive, etc. For this many years of service, ask for this or a big enough bonus or raise to cover the surgery! Paula

Can you switch insurances at the next open enrolement?

I was just approved about 3 weeks ago in CT by CIGNA. Everyone was telling me that they were one of the toughest companies to deal with. My policy stated the any form of baritric surgery is not covered unless medically necessary. My first appointments were not covered. The last 7 months or so was going through the process to get that designation. Cigna has very specific tasks that need to be documented and or completed. My surgery is scheduled for this coming Monday so sticking with it worked for me. Brian

Lobbying efforts over the past few years have failed miserably in Connecticut-- as a result, the General Assembly has never even had a full vote on any proposal to compel insurers to pay for medically necessary bariatric surgery. This year, nothing was even reported out of Insurance and Real Estate Committee (I don't recall seeing any bill having been submitted for consideration by the committee in the first instance). Without a legislative mandate, insurers are free to deny coverage for bariatrics-- it is in their short term economic benefit to deny coverage because (at least according to a Blue Cross Blue Shield Institute analysis paper) it takes approximately five post-operative years for the insurer to recoup (in savings) the cost of the bariatric surgery and a statistically significant number of people tend to stay with their insurers less than five years. It is unfair, shortsighted and very sad. But, with a little luck enough of us can start contacting our General Assembly members to motivate them to consider a bariatric insurance bill for next year's legislative session.