insurance coverage

Help...I currently work for 2 hospitals and they are both "self-insured". As such they will not cover any weight loss surgeries. I am in the process of purchasing my own health care coverage and am hoping to get pointed in the right direction. Can anyone tell me what insurance in Missouri will pay for R-N-Y?

Sally welcome to the board but im sorry i really cant tell you anything about insurance.  I am on Social Security and have Medicare which paid for mine. i think if something is an insurance company then they should have to cover wls. just my opinon.....someone from here can surely tell you if they have private insurance and it covers wls. hope you get some answers soon.

I have anthem BCBS of California they paid for mine, you might check the Missouri BCBS.  Lou ;)

Most any insurance company will cover it as long as there is not a bariatric exclusion in the policy. That is the problem because it increases the premium. So some of the group insurance coverage selects the exclusion for cost effectiveness. They just don't get it or care cause it will normally pay for itself in the long run. The costs of the co-mobilites will be resolved such as diabetes and cardio problems and overall general health problems are resolved with these surgeries. But as with everything in this world it is the immediate bottom line that matters.
Good luck,
Connie B.

How has the lap band worked for you? When did you have it done?

I am very pleased with my Lap Band. I am 57 and had all kinds of very serious health issues before surgery. I had my surgery 2 years and 3 months ago and I am down 125 pounds and still losing. I am no longer dependent on a mobility scooter (it is stored away and I do not miss it!) and am taking less than a third of the medications I was taking. I can finally live a normal lifestyle again and am thankful every day for the second chance at life. You have to be willing to follow the rules to be successful. But that is true with any WLS. They are all simply tools not a easy way of losing like a lot of thin people think it is.
I hope you are able to find a way to get your surgery. Just so you know Shawnee Mission Medical Center in Shawnee Mission Kansas has bariatric coverage. So there are some that care enough about their employees to cover it. I hope you are able to find one close to you that will.
Connie B.

Connie,
You know I have actually been shopping also for a different job and specifically asking about their insurance restrictions. I have turned down 3 jobs now because of the same "self-insured" or restrictions on wls.

Thank you ladies for your input. I was told by a family member who sells insurance just to hospitals that you have to specifically address with the company, when you buy a policy, if they have a rider prohibiting wls.  work in the health care field and the 4 hospitals I have spoken to in Missouri about it are all self-insured and won't touch it. Frustrating!!!

Sally I understand completely.  I worked in Surgery at a local hospital for 17 years.  I even went with the surgeon to learn to do RNY in STL.  We did several hundred patients but they didn't cover it in our insurance for the employees.  It was like mental torture to me to do these life saving surgeries knowing all along I needed one so bad. Still today they only do the lap band now but one of my friends was self pay and had it done.  They(the hospital) wouldn't approve her time off because they said it was cosmetic! WTH? After I quit working there we took out insurance threw my husbands job and they covered it.  Don't give up!  Lou ;)

Isn"t that rediculous...do the surgeries in the facility but won't approve it for your own hospital employees? I am looking into jobs in the STL area in hopes there might be one there who will cover it. I am hoping to find an employer or insurance company in Missouri that will do it (like your husbands). I can't imagine what it would cost out of pocket but I may have to go that way if I want to continue to work. That is what worries me so much. I have to support myself but my weight bearing joints and back are getting so bad it is making it excrutiating to stand for 12  hours a day.