I self paid for VSG in Mexico so my insurance company doesn't know that I had the procedure. Do you guys think I have to let them know or risk being accused of insurance fraud? If the affordable care act is repealed or change so that preexisting conditions are harder to insure again, do you think having VSG would be considered a preexisting condition? Has anyone else just not called their insurance company to tell them about self-pay elective surgery?

Hm. Not sure how to answer your question, but I don't plan on telling mine about my LBL/BL next month. My primary care physician will be aware because he's doing my pre-op blood work.

Plastic surgery like lbl is not a pre-existing condition. I know that RNY is.

Good to know!

That's sort of terrifying given the current healthcare climate and my upcoming revision...but so is obesity. That's about as dumb as saying people who are pregnant have a pre-existing "condition," eesh.

Sad, but true. It wouldn't surprise me that ins companies would consider a hangnail as a pre existing condition. Remember awhile back almost everything you can think of was considered a pre existing condition, looks like we're going right back to that again.

Good luck on your upcoming surgery. Good thing you're doing it now b4 ins changes again.

I have RNY in 2007 and when I needed purchase insurance in 2010, RNY was considered a pre-existing condition. It increased the rates I was charged.

What the hell? You are thinner and are at less risk for the diseases associated with obesity and they STILL RAISED YOUR RATES.

Can't win for losing can we?

As of this moment, pre-existing conditions cannot be used. However, that may change at any time. If you don't like that, write your Congressperson. The individual mandate (requirement that all people have health insurance) is likely going away in the tax bill that is on its way out of conference committee.

If you are currently insured and maintain your insurance continuously on a group basis (e.g. through an employer) it is likely you will never be asked about pre-existing conditions. If you buy on the individual market, that's a different story.

However, I don't think fraud is an issue if you do not tell your current company about a self-pay procedure. Fraud, generally, only comes into play when hide something whi*****reases the risk/cost to the insurance company. If you do everything right, your risk/costs should go down as a result of your surgery. On the other hand, if asked and you fail to disclose to a new carrier (e.g. if they ask about all surgeries you have ever had), in many states that would be fraud in the application and grounds for the carrier to revoke your policy.

I'd actually suggest consulting a lawyer more familiar with insurance companies and healthcare. I know that costs money, but they are the most likely ones to know the answer for certain. Insurance policies and evidence of coverage can vary widely by state regarding requirements, even for the same corporation, so it's good to check legal advice in your state.

I'm not sure how you'd get accused of insurance fraud, though, unless they ask for what surgeries you've had and you don't tell them. Having said that, I would definitely consult a professional familiar with the law.

Also consider that if the VSG was documented anywhere else in your medical records state-side, it's possible they may be aware already, especially if you received treatment for related issues. Whenever we provide treatment for clients or patients we must submit justification for billing for services.