Need help with insurance....
Lots of employers now have exclusions on policies. It's so sad. I'm like would they do that for heart employees or cancer employees? No, just obese employees. So not fair. I have Aetna, but as of this year they have an exclusion on their policy too. My employer's policy renewed 6/05 so as long as I had my surgery before then (which I did) it was covered. So call and see when your employers policy renews (call the 800# on the card) and have htem look up your employer's policy with your ID# and they can tell you.
You can also check out the INsurance Help message board forum on ObesityHelp.com at http://www.obesityhelp.com/morbidobesity/insurance-help/posts.html
Trisha
Unfortunately, my employers plan date (at least the enrollment) period was in/around the first of the year. Due to lack of renewals (due to increased rates and a decreased plan value) they had a 2nd one in Feb or March, so I'm sure the plan date has already taken effect. I'm at a loss because I know I won't be able to get other individual health insurance due to my ht/wt. At this point, I don't have any diagnosed co-morbs but I can be nowhere but on the path to disaster as I've been on every diet known to man and every diet drug since age 7.
Gail,
Call the pre-certification number on the back of your insurance card and find out what the criteria is. Talking to reg insurance people will get you nowhere. These are the people that know the facts. There may be a thing also where they will cover if it is medically necessary. You might check into that trail also. Don't give up!
Clara
Dr. Chiasson
lap Oct. 28, 2003
I called the only number on the card and pretended I didn't know anything about the exclusion. I asked what the requirements were for bariatric surgery. They told me that it was a particular exclusion on our companies policy and that even for medical necessity it wouldn't be covered.
My husband is starting a small business (2 employees - me and him) and I'm looking into small group insurance. My problem is ALL the insurance companies have some sort of obesity or wt loss tx/therapy or surgery for wt loss/gain(I wish). I think I need to find out what exact wording I need to look for or find out if these are listed may they be overturned for medical necessity. A General Exclusion may be overturned for medical necessity.. I think.. Unfortunately I'm not an insurance guru and there are so many wordings I don't know exactly what can be acceptable. Plus, I think since my husband is the employer he should be able to say what services he wishes to be included. And another thing, I am considered Morbidly Obese with a BMI of 50.