Can anyone answer this???

Apple.Pie
on 11/21/11 11:54 pm
I am trying to find out what insurance plans cover the DS. Can anyone who has had it tell me what insurance plan they had? Grateful for your input..........
Jeremy M.
on 11/22/11 12:07 am - Fishers, IN
I've seen people get it covered with a variety of providers.  I had Aetna at the time and had no problem getting it covered.  However, there are also people with Aetan who have not been able to get it covered.  It depends on your employer and what things they chose to cover in the plan.  For example, I was with Anthem BCBS and we had a specific exclusion on any WLS.  When my company was bought, the new company chose to cover WLS.  I would imagine this drove the premiums up (either for the employer or the employee) in order to cover these surgeries.  So, while I had an Anthem plan that didn't cover it, I know of plenty who have Anthem plans that do cover it.  You'll really need to look at the policy and how it's worded. 
Jeremy

HW 327 / SW 300 / CW 198 / GW 169
    
Apple.Pie
on 11/23/11 3:16 pm
I don't currently have insurance. I am thinking about buying a policy and was hoping to figure out what different insurances will pay for DS.... I need a RNY to DS revision............ asap
(deactivated member)
on 11/23/11 3:50 pm - San Jose, CA
An individual policy is going to be unlikely to cover WLS at all, and even if it does, will likely have a one year exclusion for pre-existing conditions.  And you may not be able to GET an individual policy at all if you are obese.
Nicolle
on 11/22/11 12:38 am
It doesn't work that way, I'm afraid. Every plan is different. One Aetna plan is different from another Aetna plan and so on. It depends what your employer purchased, whether they bought  a plan with a WLS exclusion, etc.

You need to call YOUR insurance company and get YOUR specific plan's wording. If it does not cover the DS, you may need to switch to a plan that does at open enrollment, get a different job, self-pay, etc.

BTW, I had my DS almost four years ago and Aetna approved mine.

Nicolle

I had the kick-butt duodenal switch (DS)!

HW: 344 lbs      CW: 150 lbs

Type 2 diabetes and sleep apnea GONE!

goodkel
on 11/22/11 1:45 am
Ditto what Nicolle said.

However, we do know some companies that provide plans that cover WLS for part time workers, so that is an option. Starbuck's is one and I believe Home Depot is another. There may be more.

Best of luck to you!
Check out my profile: http://www.obesityhelp.com/member/goodkel/
Or click on my name
DS SW 265 CW 120 5'7"



Apple.Pie
on 11/23/11 3:18 pm
Oh wow, I didn't know that Starbucks and Home Depot would even insure a part time employ... let alone with insurance that would cover WLS. Thanks for letting me know.......
goodkel
on 11/23/11 3:32 pm
Throwbacks to way things used to be. The way we need to make them now.

Best of luck to you!
Check out my profile: http://www.obesityhelp.com/member/goodkel/
Or click on my name
DS SW 265 CW 120 5'7"



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