Obtaining individual health insurance AFTER surgery

 Hi.  I am 22 and my parents are considering getting me self-pay VSG.  Anyway, I will go off my parent's general health insurance plan (note--it does not WLS hence self pay) when I turn 23.  I am not entirely sure of my future plans but my finger are crossed for funding for grad school (which would bring with it health insurance).  I have horrible asthma and not having insurance is a very scary prospect for me.  So, I would at least want to get an individual plan.  My question is if it is terribly hard (or prohibitively expensive) to get indiv insurance if you've had WLS.  Thanks

I am finding it all but impossible so I'm not daring to change ins co's right now. Most people I read about here find that they have to wait 3-5 years before they can get a private policy.

Hi! It is very difficult to get covrage for after care for WLS on an individual heath plan - if they accept you as a covered person, they will not pay for anything related to your surgery. I would suggest looking into a self pay program that includes as much after care as you can find. A good place to start is BLIS Surgeons, they all include complication protection for anywhere from 30 days to 18 months following surgery for banding. If something happens and you need care, your BLIS protection plan would kick in and BLIS would pay the medical bills as approved by your BLIS Surgeon. Pretty cool really - it will at least provide you with some peace of mind for 18 months. Many offices will let you pre-purchase a package of fills for 1-2 years following surgery as well! Wishing you the best of luck....let me know if you have any questions! Billie

With all due respect she is looking for insurance period... not just emergency coverage for a month.  She's looking much further down the road.

I know she is looking for long term coverage and we all know that can be hard to find. So in the meantime, I was simply letting her know about something that could help her for up to 18 months! She will have to look for a long term solution of course, this is very important! I would never recommend against that.

That wasn't her question.

 Hi there!  I'm investigating individual health care plans right now, too, and I'll share a little about what I've found out.  We have BCBS of AL, but are in the process of moving to Florida.  Moving out of state means our coverage with BCBS of AL will end.  I spoke to a BCBS of FL agent yesterday, who told me that they I must have a five-year period with no band complications before they will even consider me for a new policy.  However, I can request a "conversion" policy, which will convert my existing BCBS plan from AL to FL.  I'm making the call today to see if that will work.

Our other insurance concern relates more directly to your situation.  Our son graduated from college in December.  Although he is no longer a student, he is covered on our insurance until age 25, as long as we are still providing the majority of his financial support, and he is claimed on our taxes as a dependent.  Obviously, our hope is that in the meantime, he will become gainfully employed and have group coverage!  We also have the option of converting his policy to an individual plan on it's own, which must be done within 30 days after he no longer meets the criteria to be covered on our plan.  

You are a very wise young lady to be investigating this issue in advance.  Look up the wording on your parents plan, and/or speak to an agent.  Find out exactly when your coverage will end, whether there is an option to convert at that time, and what is the deadline for getting the conversion plan.  Regardless of the type of surgery that you have, it's likely that there will be a waiting period following surgery before they will grant an individual policy, even one that excludes care for bariatric complications.  So, conversion may be the best option, if it is available.

Tami 

Be VERY careful about what your agent tells you - insurance companies all have standard underwriting waiting periods.

If your parent's plan is through their employer, they probably have COBRA as an option.  Going off your parent's policy due to age is a qualifying event that triggers 36 months of coverage - it is expensive, since you have to pay the full price yourself.  But you will continue your coverage without that pesky pre-existing condition issue.

Here is a place to start - the US Department of Labor's page on Loss of Dependent Child Status.

Hi,

I thought I'd share my experience with you  since I am now having a different but related issue.  I have been trying to shop new insurance due the ever rising costs.

I have successfully gotten a self-pay plan through Aetna that covered my procedure originally.  However,  I have had to adjust my policy to high out-of-pocket deductibles and they have raised my premiums and increased co-pays for ER and other services.   
When seeking a self-pay plan, you are subjected to underwriting.   I tried seeking coverage through another carrier for better coverage and lower rates, but was denied due to a healthcare disclosure of the gastric bypass and elevated cholesterol.  I tried appealing, contacting GA's insurance commissioner, and OAC. All to be denied again after the appeal.

More often than not, seeking a self-pay plan will take some hunting and fighting.  I am stuck I think with the AETNA self pay plan. Even if I do hopefully, secure group coverage again I am considering keeping Aetna with a bare minimum coverage if I have another job lay off. 

Good luck. Please let me know how you make out.  Apparently, this is a growing trend among insurers that if do receive the surgeries, they are now denying future coverage with little caveats.  What I don't get is that they cover this initially and then find some other way not to carry you when I know for me, I am healthier than ever before.

Desiree
RNY 4/7/2003