Insurance search is on....

Hey all.. i need some help. Now after all this going thru waiting and all my Obama insurance does not cover my RNY.. So i was told by doctors office to search for other insurance out  of the Obama care network where they cover the RNY surgery.

I live in Pennsylvania and i'm doing the search on most health insurance, if any of you have suggestions i would greatly appreciate it. Thanks in advance.

hire an insurance agent.  They may know the insurance market.

There's no such thing as "the Obamacare network" -- there are a bunch of commercial insurance companies in the state exchanges who offer different tiers of plans based on what meets the Affordable Care Act requirements and what they find the most profitable. Some will cover WLS, some won't. Some will cover it at some tiers but not others. Some will cover it but only after a waiting period (even my employer-sponsored plan requires a 2-year wait). Just be sure to ask all the right questions while searching for plans. Good luck!

Is there anyway to obtain a different insurance plan with the affordable health care plans. I have a plan with affordable health care act and mine is covered I only have a $500 deductible.  Best of luck with finding a new plan. I hope you find one that is affordable and covers it.

Fur4Kids is absolutely correct.  There is no "Obama" plan.  The plans offered are through various insurance companies doing business in your state.  Purchasing individual coverage via the Exchanges (a state or federal marketplace) may make you eligible for a subsidy to help pay for your coverage, depending on your income level.  

While most of the benefits are similar across carriers (e.g., all plans must cover "essential health benefits" at no copayment or other cost share), other benefits offered will vary, including copayments, coinsurance and deductibles, coverage for specific conditions and procedures, and other differences.  As you can imagine, the less expensive the plan, the less coverage and higher cost share you will have.

You need to ask very specific questions of the carrier to better understand what you are buying.  Also, you may be out of luck this year for changing plans.  Unless you have what is considered a "life change"  where you qualify for a special enrollment period (e.g. loss of job with employer sponsored insurance, birth or adoption of child, moving from one state to another, etc.), the open enrollment period has passed.  You may not be able to get a new plan until open enrollment starts in November, with a January effective date.  This may vary by state, so you need to check that out.  This rule exists for obvious reasons, so that you don't purchase an inexpensive plan, and then switch to a more comprehensive one when you get sick or need an expensive procedure.  Kind of like buying car insurance after you total your car.

Good luck and let us know what you find out.

No such thing as Obamacare - well, only on Faux News!

This link may help you find out what you need to do Bariatric Health Insurance

That's exactly why i call it Obama insurance.. lol

Forget.. Thanks for the link very helpful.

As already pointed out, the open enrollment period is closed for 2015, but that gives you plenty of time to try to find a plan for 2016. According to the link Kim posted, your state doesn't currently offer bariatric surgery in any of the "state exchange" plans, but that might possibly change for next year's plans.

It can be very difficult to find an individual insurance plan that covers WLS, but -- as someone else suggested -- an insurance broker may be able to find one that does. 

Good luck with your search.  If you find something, please post it here since people come here all the time trying to find individual insurance plans that will cover bariatric surgery.

Lora

I know you live in PA but I purchased Health Republic of NJ insurance through Obamacare (I didn't qualify for a subsidy, had to pay full cost, but still much cheaper than the surgery).  It covered my surgery after some pretty typical requirements.