Post-Op Banders in AZ who need insurance

I’ve seen TONS of threads aimed towards pre-op banders looking for insurance, but not much for post-op banders. So, I figured I’d share what I’ve learned so far during my frustrating journey.

 

DISCLAIMER: This is specific to uninsured post-op banders in AZ who are 18-64. Of course, you should always do your homework and double check for yourself… I just wanted to offer a little help based on my experiences. 

 

I’m in quite the predicament right now… I recently lost my health insurance because I turned 23 and am no longer eligible for my parent’s group plan. COBRA was right around $1900/month, so obviously that wasn’t an option… therefore I could not qualify for portability under HIPAA. I’m about 6 months post-op.

 

My employer does not offer health insurance (and I’m not about to give up my job- I’m dang lucky to have one in this economy)… and I make too much to qualify for AHCCCS.

I was able to pick up temporary (6 month) catastrophic coverage for $108/month… but it does NOT cover any pre-existing conditions. Basically, it’ll only cover me for a emergencies… like if I fall off a cliff, need stitches, or break a bone. If it has to do with my gastric band… or any other “pre-existing" conditions… I’m screwed.

 

Surely I’m not the only 20-something in this position…. I’ve done a LOT of research, and have made a TON of phone calls trying to find health insurance for a post-op bander. So, I wanted to share the info I’ve gathered so far…. And hopefully save others the headache!

 

The vast majority of Arizona health plans will NOT issue insurance policies to individuals who have recently had gastric banding, even if you are totally healthy otherwise. I made some phone calls to the top carriers, and they gave me a few pointers.

 

Aetna: Must be 2 years post-op, otherwise you will be declined.

Blue Cross Blue Shield of AZ: Must be at least 1 year post-op, and maintain a healthy weight for 1 year. (Basically, whenever you reach a healthy weight… add another year).

Celtic- Must be 2 years post-op, otherwise you will be declined

CIGNA- I was told that there was no set time limit… but that my chances of getting through underwriting were slim to none, even with a healthy BMI.

CIGNA plans apparently do not cover weight loss surgery, so they are hesitant to take on WLS patients.

HealthNet- Still waiting to hear back from their underwriting department

Humana- I wasn’t impressed by their plans, so I didn’t even bother

United Health Care- Must be 5 years post-op, otherwise you will be declined.

Assurant- Still waiting to hear back from their underwriting department

American Community Mutual- I wasn’t impressed by their plans, either.

 

I'm only 6 months out, so obviously I don't qualify for any of these plans. However, I was able to find another option.For those of you are in MaricopaCounty, who cannot get insurance, and do not qualify for AHCCS, there’s another AWESOME resource available. Just so you know, I have NO “professional" affiliation with them at all… so I’m not trying to “plug" anything… I’m just a happy customer:

 

Health Care Connect

 

http://www.healthcareconnect.org/index.html

 

I found this by pure fluke… it’s a county-wide medical discount plan for folks who do not qualify for AHCCS. Of course, their website is down for maintenance right now… but they’ve been a huge help for me, since I’m now an “out-of-pocket" patient.

 

I think the membership was like $50 for the entire year… and it gives you access to medical discounts via a HUGE network of providers.

 

For example, if a hospital is in their “network," you only pay 10% of the total billed charges.

 

My surgeon (Dr. Schuster) is with Banner Gateway… so when I go in for a fill, I have to pay the hospital facility fee and other random fees…. Which is approx. $500 total.

 

Because of my Health Care Connect membership, I am entitled to their discount… so I only paid 10% of that $500…. Or a whopping $50. One visit more than paid for my yearly membership to HCC… and if I go a few times per year, I’ll be saving literally HUNDREDS of dollars.

 

Their website should be back up mid-January, so check it out if you get a chance.

 

Anyway, this whole “no insurance" thing is a real pain in the ass… but I’ll keep updating if anyone is interested. Let me know if I can help.

 

 

I am so glad that you were able to get this plan. Good luck in the coming year.

Thank you!!!

It's been a pretty massive headache trying to sort through all this crap, LOL.

The Healthcare Connect thing is useless for regular doctor visits (only because my doctor isn't in the network, and I love her too much to go somewhere else).... but it's been awesome for my fills.

I've gotta say.... it sucks not having insurance available. It's not that I'm unwilling to pay for it.... I'd happily pay $300/month for coverage.... if they'd let me sign up!! Gaaah!!! lol

This fill is a big deal for us bandsters.  Maybe if you talk to your Dr. she will only charge you a co-pay. .
Years ago,  We had quit your jobs and didn't have health insurance,  I ended up with a really bad ear infection and had to go to a specialist.  When I told him we didn't have insurance he only charged me the $25.00 co-pay.  There are Dr.out there that have a heart. 
Good Luck.

There are a lot of great doctors out there! My PCP gives me a BIG cash discount because I referred so many people to her when her practice was still new... LOL.

Thankfully I've managed just fine since losing insurance.... I'm just crossing my fingers that nothing major happens. At least not till I have better coverage LOL