Questions about buying your own insurance coverage(Aetna)

I want to get insurance through Aetna or some other insurance to get gastric bypass. Is there any type of exclusion if you are paying for the insurance yourself?? I know some employers set the standard for what is covered so I was wondering if I would get to choose the type of coverage I would want.

Thanks

Naomi

Here's the thing: buying your own individual policy will likely be expensive since you are morbidly obese, and I don't know of ANY that wil cover WLS. You would be better off getting a part-time job that offers insurance to part-timers.

 Robert:

I hope that you revealing you work in the insurance industry opens you up for a barrage of questions. lol.  There are many here that are totally confused about how most insurance works.

hugs and giggles from Baltimore

never settle for less than you deserve and you deserve the best


Lori

Sorry for the mix up on the name.

I understand the liability issue.  I am one of those would pick your brain for clarification.

I know that my current health insurnace has wls as an exclusion.  How I have been doing a lot of research to see what my chances are on appeal and I must say that with what I have found out
I feel I may have very good chance with what information I do have.   I am willing to share it with who ever it can help but want to see how my appeals process goes before I offer too much.

So stay tuned for further details.

hugs from baltimore
lori
never settle for less than you deserve and you deserve the best.

My health insurance is United Health Care and any treatment for weight loss is an exclusion regardless of medical nesesity. I have been to HR and they are looking into it and have not informed me what has been found out. 

I lilve in Md and there is a law here that states health insurance issued or delivered in the state is required to cover surgical treatment for obesity if  NIH criteria is met and it is deemed medically nessasary.  My insurance is written in California and there for governed by the state of California law. 

I have researched and been in touch with the California Commission on insurance and have found a clause that states that treatment for obesity is to be excluded, except for morbid obesity ( which I am considered) and only if for cosmetic purposes. Translation> Morbid obesity must be covered if it is not being done for cosmetic purposes.

Plus I have case law that supports that no matter where the policy is written the laws of the state where the insured can not be negated ie ignored.

So I am hoping that my employer will be able to obtain the rider.

If not then I am going to appeal and keep appealing until I can't. 

I also have researched the companies mission statement and policies and plan on using thier own words in the appeals letter.


When I went to HR I explained how many of the employees would benefit from the option as well as the benefits to the company of having healthier, more productive and happier employees.

So we will see how things go.


lori

Oh wow.... sounds like you're already on the right track, good for you!! I wish you the best of luck! :)

I have been through quite a few legal/medical matters ( meaning they are related or intertwined) not to learn from them.  I am really a research junkie.  I love to ask the questions WHY and HOW especially.

I had elective surgery 5 yrs ago and I researched that proceedure for 4 yrs before I decided to persue it.

Thank you for the best wishes. 

I will keep you posted how things progress.

I also have vowed to share all or any of my success with any one that my benefit.

Lori