Insurance in Oregon? Help!!!

Cashmere
on 8/26/07 5:57 am - OR
Hi, I reside in Portland, Oregon and am fortunate enough to have double coverage thru my employer since my husband also works for the same place.  We both have ODS. Unfortunately any surgery or services related to obesity for whatever reason are EXCLUDED.  I've beaten my head against that door and that route simply is not going to be an option. Could anyone in Oregon suggest an insurance company and plan that covered them with not too many hoops and headaches? If you had to pay privately I'd love to know what the cost is out of pocket too. I hope my insurance carrier thru work will not care if I also pay privately for insurance elsehwere at the same time (I have no idea if one can do that) as I intend to keep my work insurance and only want this additional insurance for my surgery and post care. Also I am guessing since my obesity and health problems (Acid Reflux. Sleep Apnea, major joint problems including hip surgery and plantar fasciitis and neuromas) are pre-existing the insurance company would have a waiting period before I could do the weight loss surgery.  I am going to start my 6 month diet this week (and check in with my primary care phys. each month) to at least get that started as it appears many insurance companies want that. For the record, I would ideally like to use Emma Patterson as my surgeon for my lapband surgery. Any advice would be dearly appreciated!!!  My health has taken such a beating that I ideally need to have surgery asap so I'm tryimg to get this rolling asap. Thank you in advance for any advice/input you care to give. Cashmere
Cashmere
on 8/28/07 4:55 am - OR

Just an update:

I talked to my union rep at work today (whos also the chapter chair) and she's going to be talking to our business agent at the union about my situation.

She said that our employer (The City of Portland) is self-employed with insurance (not sure if I got that right) and that ODS is the underwriter that they contract out to.

I have no idea what any of this means but if anyone does and could tell me if there's anyway the union could negotiate on my behalf with my employer to pay for the surgery I'd really be grateful. I don't know if I'm wasting my time going up this road.

Other than that, the only other option is obtaining private health insurance as an individual and thus far I've talked to Pacific Care (thru United Health Care) and Blue Cross and weight loss surgery is excluded on both plans for individuals.

Not looking good. I need lap band surgery desperately. My body is just cracking up. :o(

C

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